The new DSM-5 Autism Spectrum Disorders (ASD) diagnostic criteria finally includes sensory symptoms (e.g., over or under-responsiveness to or atypical interest in sensory stimuli) as part of the diagnosis and treatment of Autism. This inclusion of sensory symptoms under the domain “restricted repetitive behaviors” (RRB) expands sensory processing evaluation, research, and interventions related to the functional difficulties of people with Autism. Individuals with Autism and their families have long realized the practical benefits of sensory strategies on daily life, despite the criticisms of this approach by some behaviorists and pediatricians (Hazen et al., 2023).
Occupational therapists, behaviorists, mental health therapists, physicians, and other professionals are encouraged to consider the effects of signficant sensory processing differences on behavior, social skills, and activities of daily living when determining individualized transdisciplinary interventions. Assessment of sensory processing challenges impacting daily functioning using reliable, valid evaluations such as the Sensory Profile 2-Short Form can direct therapists in sequentially guiding students to recognize their arousal level and sensory awareness challenges and using effective coping strategies to improve their self-control (Ohlbock et al., 2024; Yuan et al., 20022).
The first step in intervention is to guide students toward a calm alert state by reducing sensory input, then if needed incrementally increasing input in a socially acceptable manner. Step 2 is to facilitate interoceptive body awareness then address sensory discrimination challenges. Sensory discrimination challenges are addressed by integrating the diverse sensations of functional activities (e.g., in printing “hat” on a whiteboard, the squeaking and smell of the marker with the visual and kinesthetic sensations involved in forming the letters).
Recent research regarding school interventions for ASD validates that significant school behavioral improvements result from contextual environmental adaptations (Zilz & Pang, 2021) as well as integrated sensory and mindfulness interventions that enhance interoceptive body awareness (Ohlbock et al., 2024). See Interoceptive School Strategies
Clinical experience suggests that providing a foundational awareness of the front-back, top-bottom, then sides of the body See Roll Therapyball Core Progression Strategy contributes to body awareness. Basic sensory modulation and interoceptive body awareness provide a foundation for emotional awareness and self-control.
After existing sensory challenges affecting behavior are considered they need to be integrated with a functional behavioral analysis for students with ASD and complex behavioral challenges who are not responding positively to consistent intervention. See Translating Assessment to Intervention Post. Combining sensory and functional behavioral assessments can enable the school team to develop effective, individualized, evidence-based, transdisciplinary interventions (Ohlbock et al., 2024; Yuan et al., 2022). Embracing the evolving diagnosis and clinical research regarding transdisciplinary interventions for ASD reveals a more effective transdisciplinary approach integrating sensory and behavioral strategies to better help youth with Autism Spectrum Disorders (Liscomb et al., 2023).
References
Hazen, E.P., Stornelli, J. L., O’Rourke, J. A., Koesterer, K., McDougle, C. J., (2014). Sensory symptoms in Autism Spectrum Disorders. Harvard Review of Psychiatry, 22 (2), 112-122.
Lipscomb, S. T., Swander, W., & Mason, E. (2023). Building Cultures of Care in Schools: Centering Relationships at the Intersection of Trauma-Informed Education and Restorative Practices. Contemporary School Psychology, 1-17.
Öhlböck, E., Stinson, M., McClintock, K., & Turtle, B. (2024). Evaluating the effectiveness of key components of Zones of Regulation™ curriculum training on teachers’ self‐efficacy at managing self‐regulation needs in autistic pupils. British Journal of Special Education, 51(1), 111-122.
Yuan, H.L., Lai, C.Y., Wang, M.N., Kwong, T.C.., Choy, Y.S., Mung, S.W., & Chan, C.C. (2022). Interventions for sensory over-responsivity in individuals with Autism Spectrum Disorders: A narrative review. Children, 9, 1584.
Zilz, W., & Pang, Y. (2021). Application of assistiive technology in inclusive classrooms. Disability and Rehabilitation: Assistive Technology16(7), 684-686.