Module III: Intervention of Sensory and Motor Issues in Individuals with Asperger’s Syndrome

Modulation

Modulation is the ability of the nervous system to take in and regulate various internal and external sensory stimuli. The most recent definition regarding sensory modulation dysfunction (SMD) comes from Miller and Summers.

Sensory modulation dysfunction is a problem in the capacity to regulate and organize the degree, intensity, and nature of response to input in a graded and adaptive manner [that] disrupts an optimal range of perceptions necessary to adapt to challenges in life (p. 247). ⁶

From this definition, we can see that the way we modulate input coming into our senses greatly affects our arousal level or general state of being. When we have an optimal level of arousal, our nervous system has successfully perceived, interpreted, and responded to incoming sensory stimuli. We are alert, focused, calm, ready to learn, and ready to interact with the environment around us.

When we have a low arousal level, the nervous system has a decreased reaction to the sensory input coming in and therefore doesn’t react or respond as quickly, or at all, to the input. Individuals with low arousal level find it hard to remain alert and focused, tend to seek out a lot of input in order to better register and respond to it. They may be hard to motivate and get moving, or may be in perpetual motion. For example, imagine you are at a lecture and you only had three to four hours of sleep the night before. Your whole system is so over tired that you find it hard to pay attention, sit upright in your chair, use a writing instrument, or even stay awake. The lighting in the room is very low, your seat is soft and reclines back, and the speaker talks in a very monotone voice. You might be trying anything you can think of at this point to stay awake. Examples might be tapping your leg, chewing on your pencil, drinking an ice-cold beverage, or standing up and stretching every so often.

People with a high arousal level often respond to sensory stimuli with a strong response, frequently a fight/flight/fright response. They may flee from sensory input and seek a smaller, quieter space to get away from too much input or they might scream in fright when confronted with too much sensory input. Sometimes people become aggressive when dealing with an overabundance of sensory stimuli and strike out against the person or object producing the input. They also may have a hard time remaining focused or calm in busier environments such as a grocery store, mall, social gathering, or school cafeteria. Imagine that you are in the same lecture, but this time you have had a very stressful morning getting ready and out of the house. Your car won’t start right away, then you sit in unusual traffic, and finally you realize that you’ve forgotten your wallet at home and it’s too late to go back for it. You now sit down in your seat for the lecture and a workman with a jackhammer starts to work right outside of the room. Then, you find that the florescent lights right in your line of vision are blinking, fluttering and making a strange humming noise. The table that you are working on is unstable and keeps shifting from side to side as you lean on it; and finally, there is a person behind you who insists on repeating everything the lecturer is saying out loud. At this point, you are probably finding it very difficult to pay attention to what the lecturer is saying, which is only making it harder for you to remain in this environment. You might try getting up and leaving the room for a minute or two, taking some deep breaths or trying relaxation techniques, chewing a piece of gum, or squeezing a “stress ball” or other type of squishy ball.

We all have peaks and valleys in our arousal levels throughout the day. However most of us manage to maintain an appropriate level of arousal by the some of the strategies listed above to interact effectively with the environment. People who have difficulty maintaining an appropriate level of arousal spend more time in a high or low level of arousal and may constantly seek or avoid input to try and regulate arousal.

Here are excerpts from Kenneth Hall’s book Asperger Syndrome, the Universe and Everything that depict difficulties with modulating sensory input. Kenneth Hall is a young man who is diagnosed with Asperger’s Syndrome.

One thing I don’t like is crowds. For example, I just hated the classroom. The noise annoyed me. At the time the sound of the children’s chatter was like dynamite going off in my ears… I think AS people sometimes feel things differently. They might be very sensitive. For me, one weird thing is I seem to be immune to certain pains. Like recently I was sick during the night without knowing it till the morning. Other times I feel things intensely. … I am very sensitive about my hair. I really hate it touching my forehead. One thing I used to do a lot was to shake my head over and over. This was really because of the annoying hair problem…. I used to go to the barber but in the end I just couldn’t put up with him any more at all. I think he deliberately drove the scissors into me. … The thing I absolutely hate most is trying anything new. There are hardly any foods I eat at all. I especially hate any food with bits in it, or things mixed together with each other, like cheese mixed with bread in a cheese sandwich, or mixed colours of foods. Sometimes I can eat a bit better if I am left on my own. Most food has a horrible texture. Like mashed potato for example. It is like paper which has been soaked in water. It feels papier mache which might go into every crevice of my mouth like a sculpture. …I hate rough fabrics against my skin, for example wool, and I don’t like labels sticking into my skin(p. 44-49).⁴

Kenneth also talks about some strategies he uses to relax himself when he’s feeling overwhelmed by his environment; “I like to sleep in a sleeping bag at night, which I do almost all the time. Even during the day I like to be in my sleeping bag as much as possible I love it so much. My sleeping bag feels brilliant; it is so cosy. The fabric of it is just perfect. In my mouth I like the feel of Pringles best because they are noisy and crunchy, and I quite like drinking through a straw. I also like the feeling of the electric toot brush in my mouth and the rubber gloves in the dentist. I like being alone. I prefer being on my own a lot of the time and I hate crowds big time. I’m also not keen on strangers coming into my house. One thing which upsets me is the noise of the chatter when there are a lot of people together. If I am upset about something being alone helps”(p. 32,47-49). ⁴

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