In Anatomy of Autism, the author Diego M. Pena, a nine year old boy with Autism writes: “The reality of Autism is generally not understood by the neurotypical world. The many things that make us autistic should not be seen as something flawed. We are capable of being heroes, but our abilities are as unique as our disabilities. So more people need to look at what we can do and not at what we can’t do.”
Much of the awareness concerning Autism is related to the challenges faced in communication and social interaction. However, the awareness or acceptance of challenges arising from sensory and motor systems of an autistic person is subservient. The sensory system for an autistic person creates many hardships in daily living. The motor planning is challenging because the brain and body (the “mind-body dualism” that is ever so taken for granted) is disconnected for such individuals.
The Autistic Sensory Experience
Imagine yourself to be in a room full of things that you hate. Now picture how that would make you feel – calm and relaxed or bursting with anxiety and frustration. Most people would inevitably choose the second option. This is the mysterious sensory world of Autism.
The sensory system of children/ adults with autism is in constant overdrive. This makes it increasingly challenging for them to participate in our everyday usual environments. We possess the same senses; however, the brain processes the sensory input/ information intensely for an autistic individual. In other words, an autistic person experiences his/ her surrounding far more intensely than the rest of us, making it almost impossible for them to cope. We have something called the Selective Filter of Attention – where we can tune out all background sensory information and focus on what we want to, whenever we want to, a luxury most autistic individuals have not experienced.
Unsurprisingly enough, the reality is that many of the so-called “autistic behaviours” – repetitive body movements like hand flapping, rocking, and spinning, peculiar interests and attachment to specific objects – are coping behaviours that the individual engages in, as the anxiety pushes their body to constantly react to their sensory system. The stimuli for them are always different and unexpected, as if they were not part of a large coherent pattern. It is a world of confusion and chaotic sensations where they often feel they are “going to pieces”, but cannot often adequately express their feelings.
The sensory features frequently seen in Autism Spectrum Disorder (ASD) are currently conceptualized to include the following. It should be noted that all of the features are not seen in an autistic child/ adult.
- Hyper-responsiveness – an over-reaction to sensory stimuli,
- Hypo-responsiveness – a decreased response to sensory stimuli,
- Sensory seeking – behaviors aimed at pursuing intense or unusual sensory stimulation,
- Enhanced perception – acute awareness of sensory stimuli.
The sensory system of different individuals with Autism may have varying degrees of difficulties processing and coping with the range of sensory information. The difficulty lies in the inability to filter out all the background information. So, they experience everything intensely at all times. Some individuals hear everything intensely – hyper sensitive to auditory stimulation. Some may struggle with seeing, touch and taste sensations. When an autistic individual is hyper sensitive to visual stimulation, he/she sees things intensely; meaning, that it is very distracting for the child/ adult to focus on a particular task or activity as easily as the individuals of the neurotypical world would. A touch sensation can be either perceived as good or bad by such individuals depending on their liking for physical contact (tickle, massage, hugging, etc). some may find smells to be overpowering.
On the other hand, taste sensations can be tricky – a child/ adult may like the various tastes, but may have trouble adjusting to the different textures of food. Also, feeding problems arise if they cannot handle the taste sensations of some food or the textures of some food. Parents, caregivers and educators should keep in mind that force feeding is not a good idea in such cases, as the autistic individual finds it overwhelming to cope with the sensory experience of taste sensations. In addition, force feeding may lead to aversion to food altogether, and may provoke feelings of fear and anxiety. Their world is one where nothing seems constant – everything is changing and seems strange.
When dealing or with such children, one should take a moment to stop and think: Would we like if our world was a frightening world that presented painful stimuli that could not be mastered as per others’ expectations?
If you truly want a glimpse into their sensory world, imagine this… Your mind is a room where several radios tuned to different stations are blaring out voices and music, and the only relief is to sleep from exhaustion. To make matters worse, your sensory system– the unrecognized editor of senses – is flooding you with sensory input, overwhelming in its quality and quantity. Colours and patterns swim in front of you, clamoring for your attention. The feel of your once comfortable clothes might even begin to feel scratchy and you may get the feeling that your legs are brushing against unpolished wood. The smell of fabric softener from your clothes becomes so strong you cannot focus on any other smell. Your vestibular (sense of balance and spatial orientation that enables coordination) and proprioceptive (sense of body awareness that arises from controlling force/ pressure) senses are also out of tune, so that the floor feels like it is tilting and swaying like a boat in heavy seas. Effectively, you are no longer sure where your hands and feet are in relation to the rest of you. You hear your loved one calling out to you – giving more instructions? Getting annoyed by your incapability to talk and be coherent? Or maybe did you hear them say that you will never learn? – You do not know for sure, because their voice seems to be coming from the end of a tunnel. You are no longer able to comprehend what is going on around you. This almost sounds like a scene from a movie or a poem. But poems and movies come to an end, but this becomes your new ongoing reality, interspersed with moments of coherence. Autism is a life-long condition. So, children/ adults with autism, in their own unexpressed way, hope to express to you that you never give up on them.
The Motor Planning and Repetitions
It is a major challenge for most autistic individuals to get their body to work with them. This leads to problems in Motor Planning or Dyspraxia (a developmental disorder of the brain in childhood causing difficulty in activities requiring coordination and movement). For them, the brain and body do not communicate messages the way it does for typical individuals. To put it simply, it’s like when you lose your Wi-Fi connection and your YouTube video keeps loading. This is the reason why talking and writing becomes challenging, learning new skills feels like rowing upstream in a river, against its current. For them, the biggest hurdle is to pay attention to their brain instead of their body – it takes serious practice, patience from caregivers, and frequent words of praises.
Every day, a child is exposed to situations s/he has never experienced before, and given opportunities to master new skills. Learning to perform a new task requires Praxis, the ability of the human brain to conceive, plan, and carry out a sequence of events.
The simplest tasks require much more planning than most of us realize, because we learned them when we were very young. The first time, or the first few times, a child performs a novel task like getting juice out of the refrigerator, putting his/her shirt on, or printing his/her name, it takes a lot of conscious thought to get all the steps in the right order to reach the goal. With time and repetition, these steps became automatic. The child is made to repeat again and again, and quickly gains the motor planning skills needed to get dressed, write, or prepare a snack. Children with autism have some of the following difficulties with motor planning:
- Trying to do a task exactly the same way every time, and not adapting to variable situations
- Not being able to complete tasks with several steps
- If they attempt the multi-step task, they get the steps out of order or leave some out
- They have a hard time imitating a task when shown, but can do it spontaneously. This is one of the hallmarks of motor planning problems, or dyspraxia.
People with autism can be very restless and fidgety. The most frequently asked question is why do they flap their fingers or hands? This has been beautifully explained by a thirteen year old boy called Naoki Higashida in his book, The Reason I Jump. He gives us insight to the fact that flapping fingers or hands in front of the face allows the light to enter the eyes in a pleasant, filtered fashion. This filtered light feels soft and gentle; however, the direct “unfiltered” light acts like needles and finds its way into the eyeballs of individuals with autism in the form of a sharp straight line.
Others enjoy spinning themselves round and round or even gradually project it on an object and finds peculiar interest in spinning these objects. They find fascination in spinning objects, simply because everyday objects do not rotate. Most of us would find it peculiar and meaningless, but to them it may just be a form of bliss they like to engage in, or maybe they enjoy the perfect regularity with which the objects spin. Most of us have our own unchanging things/ interests/ that comfort us, similarly, the autistic individuals find such unchanging things as comforting.
The brain of such individuals is wired differently and it is something we may not be able to fathom even if we read up about it. The core of the issue is that their sensory integration skills are challenged. This means their ability to take in information from their body, and interpret and use it to tell them how they should be moving is challenged.
Besides this, they have issues with their vestibular system. It is located in the inner ear, and tells you where your body is. Individuals on the Autism Spectrum cannot process the vestibular information accurately—they often get either too much information or get over stimulated or too little information (under stimulated) and need more input. Put all of these factors together, and you can see why motor planning problems are sometimes the first sign of autism. Children may be slow in learning tasks, or seem clumsy, scared, or hyperactive, before they are even diagnosed with a spectrum disorder.
When one encounters such individuals, as a psychologist, therapist, special educator, and as a caregiver, never give up teaching them, because they are capable of learning – just at their own pace. Compassion and patience are virtues we all possess and talk about – these virtues change everything.
References
Pena, D. M. (2017). The Anatomy of Autism. Middletown, USA.
Higashida, N. (2017). The Reason I Jump. New York: Random House.
Shaheli Mukherjee
Special Educator,
Ishanya India Foundation.