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Autism & Asperger’s Syndrome. Conference Summary: Susan Hines and Ashley Hart. Carol Kranowitz Summary Sensory Processing Disorder- Atypical reactions in the Central Nervous System to ordinary sensory experiences causing…

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Autism & Asperger’s Syndrome

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autism asperger s syndrome

Autism & Asperger’s Syndrome

Conference Summary:

Susan Hines and Ashley Hart

carol kranowitz summary www out of sync child com
Carol Kranowitz
  • Sensory Processing Disorder-

Atypical reactions in the Central Nervous System to ordinary sensory experiences causing…

Atypical responses in work, play, and relationships

the biggies
The “Biggies”

Hallmarks of SPD:

  • Avoiding ordinary touch and movement
  • Seeking excessive touch and movement
  • Difficulty making one’s body cooperate (coordination)
sensory modulation disorder sensory over responsivity sor
Sensory Modulation Disorder:Sensory Over-Responsivity (SOR)
  • “Sensory avoider”
  • Fearful and cautious, or
  • Negative and defiant
  • Quick, intense “fight or flight” response to harmless sensations
  • Most emotionally laden
  • Aka: Defensiveness
sensory modulation disorder sensory under responsivity sur
Sensory Modulation Disorder:Sensory Under-Responsivity (SUR)
  • “Sensory disregarder”: inattentive, self-absorbed, disengaged
  • Slow, sluggish responses to ordinary sensations; lost; loose and floppy
  • Intense sensory input needed to get in gear; may bite self or inflict pain on others
sensory modulation disorder sensory seeking craving ss
Sensory Modulation Disorder:Sensory Seeking/Craving (SS)
  • “Sensory craver” or “bumper and crasher”
  • Constant search for more, more, more!
  • Sensory input helpful to reduce impulsive, dare-devilish behavior and tendency to get into trouble
sensory discrimination disorder sdd
Sensory Discrimination Disorder(SDD)
  • “Sensory jumbler”
  • Difficulty in differentiation among and between stimuli (often visual and auditory)
  • Difficulty evaluating external or internal sensations to produce adaptive responses
  • May or may not coexist with SMD
sensory based motor disorder postural disorder
Sensory-Based Motor Disorder:Postural Disorder
  • “Sensory Slumper”
  • Difficulty with:
    • Movement
    • Stabilizing body while moving or resting
    • Bilateral coordination, balance, and crossing the midline
  • May involve fatigue, slumping, overflow, and associated movements
sensory based motor disorder dyspraxia
Sensory-Based Motor Disorder:Dyspraxia
  • “Sensory Fumbler”
  • Difficulty with fine motor, gross-motor, oral-motor output
  • Clumsy, inflexible, inactive behavior
  • Preference for familiar rather than novel
possible co existing disorders

Asperger Syndrome


Bipolar disorder

Down Syndrome


Fragile X

Fetal Alcohol Syndrome

Obsessive compulsive disorder

Oppositional defiant disorder

Pervasive Developmental Delay

Prader-Willi Syndrome

Selective mutism

Possible Co-Existing Disorders
visual problems associated with spd
Visual Problems Associated with SPD
  • Difficulty with visual-spatial processing (ability to interpret and respond to what the eyes see)
  • 90% visual problems never diagnosed
  • 25% all school-age students and 70% juvenile delinquents have undiagnosed visual dysfunction
  • Problems: visual discrimination, attention and memory
spd adhd ld
Attention-Deficit Hyperactivity Disorder (ADHD)

Learning Disabilities (LD)








sensory or




Alternative Diagnoses:



Visual problems

Speech and language problems


Nutritional deficits


Not enough recess!

Normal child under 7!

Sensory… or ???
spd vs adhd
Kids with SPD often:

Are clumsy

Prefer same-old, same old

Can inhibit impulsive behavior

Tend not to habituate to sensations

Kids with ADHD often:

Are agile; “sprinters”

Love novelty and diversity

Cannot inhibit impulsive behavior

Do habituate

jed baker phd www socialskillstrainingproject com
Jed Baker,

Autism Spectrum Disorders

  • Social Difficulties
    • Initiating and Reciprocating
  • Language Difficulties
    • Semantic and/or Pragmatic
  • Repetitive Behaviors/ desire for sameness

Associated issues:

    • Learning Issues
    • Motor Issues
    • Sensory issues: Tactile or noise sensitivity
    • ADHD, OCD, Tourettes
difficulties associated with challenging behavior
Difficulties Associated with Challenging Behavior
  • Difficulty with abstract thinking and perspective-taking
    • Misbehavior is often unintentional! Teach perspective more than discipline.
  • Inflexibility: Limited problem solving
    • Learning facts is more enjoyable than socializing.
    • Preparation and expanded problem solving avoids meltdowns
  • Low frustration Tolerance: Difficulty with Thinking-Feeling Connection
    • Concept of Emotional Hijacking
    • Prevent rage and distract when in rage
behavior management
Behavior Management
  • Step 1: Relationship Issues
    • Feeling competent: 80/20 rule
    • Avoid power struggles: problem solve together
  • Step 2: Crisis Management
    • Distract, soothe, or ignore when logic is gone
    • Make a plan for next time
  • Step 3: Repeat Behavior Problems
    • Explore why it happens: Interview, observe, and keep an ABC journal (Before, During, After)
    • Develop a good prevention plan
typical triggers
Typical Triggers
  • Biological issues: hunger, tiredness, illness
  • Sensory issues: noise, light, touch, over-stimulation, boredom
  • Lack of structure
  • Challenging or new work, feared situations
  • Having to wait, not get what one wants, disappointments
  • Threats to self-esteem: losing, mistakes, criticism
  • Unmet wishes for attention: ignored, want others to laugh
temple grandin a good teacher is gently insistent
Temple Grandin“A good teacher is gently insistent.”
  • Attention shifting slowness occurs with many disorders
  • Takes longer to shift back and forth between two different things
  • “All my thinking uses specific examples to create concepts.”
  • “It is bottom up thinking and not top down thinking.”
  • “I learned ALL concepts using specific examples.”
  • Fear is the main emotion in Autism.
signs of visual processing problems
Signs of Visual Processing Problems
  • Finger flicking near eyes
  • Tilts head
  • Hates escalators
  • Hates fluorescent lights
  • Difficulty catching a ball
  • Eye exams may be normal
interventions for visual processing problems
Interventions for Visual Processing Problems
  • Incandescent lamp by desk
  • Block fluorescent lights with a hat
  • Laptop computer
  • Gray, tan, or pastel paper
  • Irlen lenses or pale colored glasses
  • Balancing games-sit on ball
  • Prism glasses-Developmental Optometrist
severe sensory problems
Severe Sensory Problems
  • Background noise problems
  • Mono channel
  • Body boundary problems
  • Often an auditory thinker
  • Best book: How Can I Talk If My Lips Don’t Move: Inside My Autistic Mind by Tito Rajarshi Mukhopadhyay
what have scientists learned
What Have Scientists Learned?
  • Sensory problems are real
  • Immature lower brain area
  • Abnormal circuits between different brain regions
  • Sensory problems are variable
  • Many word based tasks are processed in visual areas of the brain
  • Frontal cortex is used less because it has missing circuits
develop talents in the individual s specialist brain
Develop Talents in the Individual’s Specialist Brain
  • Photo Realistic Visual Thinking- poor at algebra
  • Pattern Thinker Music and Math- poor in reading
  • Verbal Facts Language Translation-poor at drawing
  • Auditory Thinker-visual perception fragmented

**There can be mixtures of these thinking types

sensory and neurological problems that may need accommodations
Sensory and Neurological Problems That May Need Accommodations
  • Screams when the fire alarm rings
  • Cannot tolerate scratchy clothes
  • Poor handwriting
  • Tantrums or hyperactive under fluorescent lights
  • Difficulty multitasking
  • Difficulty with long verbal directions
dr tony attwood making friends and managing feelings
Dr. Tony Attwood:Making Friends and Managing Feelings

Autistic Personality:

  • Impairments in verbal and non-verbal communication
  • Empathy not as mature as one would expect
  • Difficulties with social integration and making friends.
  • Tendency to be teased by peers.
  • Egocentric preoccupation with a specific topic of interest.
  • The need for more assistance with self-help skills and organizational abilities than on would expect.
  • Motor clumsiness.
  • Hypersensitivity to some sensory experiences.
  • Tendency for some children to develop conduct problems
  • Much more common in boys than girls. 3:1
asperger s syndrome in females
Asperger’s Syndrome in Females
  • Coping and camouflaging mechanisms of “hiding” and “mimicking”
  • Tendency to “disappear” in a crowd
  • Single friend who provides guidance and security
  • Observe and try to understand before they make the first step.
  • Apologize and appease
  • Less disruptive and so less likely to be noticed
  • Learn that if you are good, you are left alone
  • Faster rate of learning social skills than boys with AS
  • Imaginary friends
  • Tom Boy- not interested in fashion
  • Male brain (mathematics and engineering)
  • May only come to the attention of clinicians when there is a secondary mood disorder.
4 reactions to being different
4 Reactions to Being Different:
  • Depression and isolation
    • Increased social withdrawal
    • Reduced motivation and energy
    • Risk of self-harm and impulsive or planned suicide attempts
  • Imagination
    • Imaginary friends
    • Inhabiting an imaginary world
  • Arrogance
    • Invariably someone else’s faulty
    • Ruminate over past injustices
    • Argumentative: use accurate recall of what whas said or done to prove the point
    • Deal with exclusion and estrangement by acting superior
    • Tend to attribute malicious intent to accidental or friendly acts
  • Imitation
    • Becoming an expert mimic (successful strategy that is popular with peers)
    • Learning how to act in social situations
qualities and difficulties
Honest (to a fault)


An expert

Notice sounds others do not hear


Speak their mind

Enjoy solitude


Reliable friend

Making friends

Managing feelings

Taking advice


Knowing what someone is thinking

Being teased

Showing as much affection as others expect

Qualities and Difficulties
  • 2 deep within the brain that connects to the frontal lobe
  • Part of limbic system-responsible for fight or flight.
  • Scans for danger
  • In a person with ADS it is 10-15% larger than it should be (sees danger when there isn’t any)
  • Less white matter connecting to frontal lobe to cool it down.
  • Anxiety:
    • Very good at worrying
    • Pessimist
    • OCD (25% of adults with AS)
    • Controlling and oppositional
    • Fear of making a mistake
    • PTSD from being teased or bullied
  • Depression
    • Occurs in 1 in 3 adolescents and adults
    • Low self-esteem due to being rejected and ridiculed by peers
    • Painful awareness of being different
  • Anger
    • 2 out of 3 people with AS have a problem with anger management
    • Sadness and anger expressed as anger