Falling under the umbrella of autism spectrum disorder are such developmental delays as autism, Asperger syndrome, pervasive developmental disorder, childhood disintegrative disorder, and Rett's syndrome. What these disabilities have in common is an impaired ability to communicate, from total isolation at the severe end of the spectrum to social awkwardness at the lighter end. They also share a difficulty with sensory processing.

Sensory Behaviors

Many so-called “autistic behaviors” have a strong sensory component. Although they may seem to be signs of detachment from reality, when looked at from a sensory perspective they may be seen to have an important function in helping the child deal with faulty sensory information. Occupational therapy may be effective in lessening the behaviors or in giving the people who work with the child a framework for understanding them.

Stereotypical Movements

The hand-flapping, rocking, jumping, and other apparently purposeless movements often performed by children with autism are also seen in children with sensory integration disorder. From a sensory integration perspective, these motions are not purposeless at all, instead, they provide intense input to the vestibular and proprioceptive senses. The same may be true of children with autism spectrum disorders.

Rather than try to stop the movements outright, occupational therapists with a sensory integration approach might work to provide the child with more acceptable opportunities for proprioceptive input throughout the day.

Avoidance of Eye Contact

Refusal or reluctance to make eye contact is a key feature of children on the autism spectrum. It seems symbolic of a refusal or inability, to communicate or to recognize the presence or importance of others. The same resistance to eye contact is seen in children who are overstimulated by input from the visual sense. They may find a direct gaze too intense, or be too distracted by the many features and movements of the other person's face to pay attention to words. Occupational therapy with a sensory integration approach might work to make children more comfortable with visual stimuli, rather than on enforcing eye contact.

Resistance to Touch

Children on the autism spectrum often do not like to be touched, rejecting hugs and other forms of affection. Tactile oversensitivity is common among children with sensory integration disorder, and the methods used to treat it are often helpful to children on the autism spectrum. These might include activities involving deep pressure and brushing. Children on the autism spectrum may particularly prefer touch that they can personally control over touch that comes to them unexpectedly.

Oversensitivity to Sound

Extreme over reactions to loud sounds such as sirens or alarms are common in children on the autism spectrum, as well as with children with sensory integration problems around the auditory sense. Occupational therapy with a sensory integration approach can help reduce sensitivity to sounds and suggest other ways to relieve the stress of an auditory overload.

Perseverative Play

Children on the autism spectrum tend to concentrate solely and obsessively on one particular activity and to be highly resistant to change. That activity may be something as simple as lining up toys or dangling keys. Sensory integration problems that impact motor planning can play a part in this, making a series of movements that have been worked out and organized more appealing than trying something different. Occupational therapy to improve motor planning, as well as play that very slowly and gently moves the child toward variations, can be more effective than simply insisting on change.

The Big Picture

Not all children with sensory integration disorder have autism spectrum disorders. Even children who show the autistic behaviors mentioned above are not necessarily autistic. However, children who are on the autism spectrum most likely have some degree of sensory integration disorder and can benefit from therapy with a sensory integration approach — or at least an understanding of sensory integration informing their treatment.