Module I: Description of Sensory and Motor Problems in Asperger’s Syndrome and Impact on Function

Significance of Sensory Problems

First person or parental accounts indicate that, when present, these sensory problems can significantly interfere with daily function and can also significantly effect the lives of the people around the person with Asperger’s Syndrome. Problems with touch and sound are the two areas mentioned most frequently. The feel and tightness of clothes can be problematic. In her book, Eating an Artichoke, Echo Fling talks about her son’s insistence on wearing sweat pants and flannel shirts because other fabrics seem to be irritating to him. She describes a particular incident one Halloween:

One year Jimmy had obsessed for months about dressing up as “The Mask”, a character made famous by the actor Jim Carrey. Jimmy had looked forward in the worst way to wearing his costume. Luckily I was able to find it that year, and it did not come cheap. When it came time to prepare to go out, things quickly deteriorated. Jimmy dressed in his costume only to find that he couldn’t stand the feeling of it on his skin. I watched in surreal shock as he literally clawed the costume off his body. As he looked at the pile of brightly colored fabric at his feet and realized that there was no way he could wear the costume that he had anticipated wearing for months, the frustration and disappointment were clearly evident on his face. Why, oh why were the simplest pleasures such a difficult thing for my sweet son? My heart broke to see Jimmy’s pain. I hate Halloween (p. 157)⁴.

Fling also talks about how Jimmy tended to avoid his father and the sadness this caused the father⁴. When trying to figure out why this might be, she noted that the interaction between her daughter and her husband was quite physical with lots of hugging, tickling, and kissing. These were not behaviors that Jimmy tolerated well. When she pointed this out to her husband and they talked about less physical ways of interacting with Jimmy, it only took three weeks for things to improve and father and son became closer.

Like the Halloween incident described above, responses to unpleasant touch sensations can be violent and excessive. Stephen Shore describes a childhood incident in his back yard when he went to hang by his knees from the metal bar of his swing set. The freezing cold bar under his knees set him into such a fit of rage, he got off the bar, down on his hands and knees and hit his head on the flagstone patio hard enough to require emergency room treatment⁸.

Loud and unexpected noise can also be problematic. One mother who has Asperger’s Syndrome, describes how disappointed and sad she was when she could not go into a store in the mall with her teenage daughter because the loud music being played was so aversive to her.¹⁰ Another adult with Asperger’s Syndrome writes that it is “kind of like someone turned the volume of the universe all the way to high” (p. 350)⁵. Sensitivity to smells, taste, food texture and to light have also been reported.^4,5,8

Understanding these problems is important. Parents indicate that recognition of their child’s sensory issues helped them understand some of their child’s unusual or disruptive behaviors. Fling indicates that it was only after she read a book by Temple Grandin that she was better able to understand her son’s behavior.⁴ (Grandin has written extensively about her experiences as a person with Higher Functioning Autism/Asperger Syndrome. For more information about Grandin go to http://www.autism.org/temple/visual.html or review her two books, Thinking in Pictures: And Other Reports from My Life With Autism, and Emergence: Labeled Autistic, at Amazon.com).

Fling writes:

“For the first time I could understand the motivation and reason behind many of my son’s behaviors. Her [Temple Grandin’s] description of sensory issues such as sound and touch provided a whole new perspective. Now I understand why Jimmy puts his fingers in his ears when a baby cries! The noise to him was the equivalent of someone running fingernails against a chalkboard. Now I understand why he avoided rambunctious play! The sensory stimulation was overloading his system. Now I can empathize with my son over his rigidity when it comes to clothing choices and food preference. His skin in ultra sensitive to textures (p. 128).⁶

Another mother writes:

It was here [preschool] that I learned about sensory integration disorder. This has to do with difficulties John had with sound, light, smells, and tactile sensations (taste seemed to present less of a problem although he was and is finicky about creamy textured foods). Sensory integration disorder explained many idiosyncrasies - why he liked to have his legs covered as a baby, and why as a youngster he chose to wear long soft clothing even on hot days, even having his hood up unless I fussed at him to pull it down. His tactile defensiveness [another name for tactile sensitivity that causes emotional responses to stimuli] also explains why he panicked to feel his hands messy with anything gooey. It explained why he complained about the smell of the school bus, why walking into a grocery store brought out the worst in him…. Sensory integration was only one of the problems John was having but it seemed to touch every aspect of his day (p18).⁶

The outward manifestations of sensory problems are often seen in noncompliance and/or rages/meltdown behaviors that are out of proportion to the situation or stimulus. These are not behaviors that serve the child well. Obviously not all “non-compliant” or “rage” behavior is caused by sensory issues. However, when these behaviors occur, the role of sensory problems should be kept in mind.

It should also be noted that persons with Asperger’s Syndrome might use sensory and/or motor activities to help maintain their equilibrium when overwhelmed. Wiley, an adult with Asperger’s, describes her “comfort kit”.

My purse holds my comfort kit. It is typically stuffed with ear plugs I can use to shut out chaos, a small bag of eucalyptus smelling salts I turn to when smells gag, a squishy ball I can set my jitters on, a bendable toy I can concentrate on when my focus wanders to far…. big sticks of bubble gum to occupy my mouth, a spritz bottle of mineral water I use to cool my hot face….My emergency kit. I think everyone should have one” (p 35)¹⁰.

As indicated above, Stephen Shore ⁸ talked about riding his bike and using a swing to gain some sense of “sensory equilibrium”, Wiley ¹⁰ had her “comfort kit” and as a child, Alex Michaels (interview in exercise 3) wrapped her limbs in duck tape to gain a feeling of comfort. Persons with Asperger’s Syndrome may need help in adapting their environment for maximum comfort and function. They may also need help in understanding their feelings and reactions to sensory events as well as help in learning ways to make life more comfortable. How much better it might have been for Alex if another way had been found for her to be comfortable rather than having to wrap her limbs in duck tape! The third module in this course will discuss intervention for motor and sensory problems particularly when they interfere with everyday function and behavior.

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