In the world of Autism, we often encounter boys and girls who develop what we call hyper or hyposensitivities. These consist of an increase (hyper) or a decrease (hypo) in the ability to perceive one of the five senses as well as pain. The most common are auditory hypersensitivity and hyposensitivity to physical pain.
Work in this area is complicated, as there is no standard rule that people with ASD (Autism Spectrum Disorder) follow; rather, one person may show an infinitely different range of sensitivity than another. Therefore, the therapeutic bond, good training in ASD, and personalized therapy tailored to the patient’s needs are essential for their evolution.
What is Hyposensitivity?
To this day, the reason why people with Autism Spectrum Disorder exhibit these hyper/hyposensitivities is still unknown. The strongest theory is that of Dr. Nadine Gogolla, a neurobiologist, who suggests an involvement of the insula. According to an article published by Pilar Quijada, following Dr. Gogolla’s theory, experiments with animals (mice with ASD behaviors) have shown an imbalance within the insula regarding excitatory and inhibitory neuronal connections. In other words, a single sensory stimulus (e.g., a noise) causes such an intense response (auditory hypersensitivity) that even if another stimulus is added (e.g., touch), it is not processed. That is, a single stimulus can saturate the entire system.
Intervention in Sensory Alterations
Currently, we find two lines of intervention for sensory alterations: that of primary reflexes, contributed by Dr. Harald Blomberg, a medical doctor and psychiatrist, and the sensory integration approach by occupational therapist and psychologist Anna Jean Ayres.
From the first approach, it is considered that the sensory difficulties of children with autism are due to not having correctly integrated primary reflexes from infancy. Primary reflexes are automatic movements directed from the brainstem that we have since infancy and allow us to survive and adapt to the different developmental demands presented to us. When these are not well integrated, they cause neurological development to be altered, resulting in difficulties in gross and fine motor skills, as well as in sensory and cognitive perception.
Therapeutic intervention from this approach consists of the correct integration of these primary reflexes using the Blomberg Rhythmic Movement Training technique, which involves imitating the reflexes that should have been acquired in childhood to correctly integrate them and allow the brain to mature according to its chronological age.
From the second approach, it is considered that the sensory difficulties of autistic children are due to not properly carrying out the sensory integration process (information registration, orientation and attention, interpretation, response organization, and execution) that develops during the first seven years of life.
A taxonomy is established to address difficulties based on where there is interference in this processing of sensory information received or returned (Viader, 2015):
1. Sensory modulation disorder:
– Hyporeactivity (lack of reaction).
– Hyperreactivity (explosive or avoidance responses).
– Sensory seeking of stimuli and experiences.
2. Sensory discrimination disorder:
– Lack of understanding of information.
– Motor discoordination (postural control, bilateral coordination).
– Dyspraxia (learning failures).
Recommended Classroom Activities for Hyposensitivity and Hypersensitivity
Intervention from this approach is carried out using sensory rooms. Furthermore, only occupational therapists can perform the relevant activities within the sensory room. Through 50-minute sessions, various materials and games are used to work on and correct the affected channels in processing external inputs and the child’s outputs.
In this case, the multidisciplinary work of occupational therapists who correct these sensory disorders, together with the psychologist’s work to address and anticipate all reactions triggered by hyper/hyposensitivities, offers the best prognosis for people with ASD.
Finally, for adequate sensory integration in autism, it is recommended to use the different elements of sensory rooms, especially to increase the arousal of those with a low tone and to reduce excitation in those with a higher arousal tone (thus integrating Dr. Gogolla’s theory), and to intersperse sensory breaks, such as doing ten jumping jacks between activities that require greater concentration (e.g., academic tasks), as it helps reduce anxiety and put the system back on alert.