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Sensory and Other Problems Associated with Autism

Interactive Autism Network at Kennedy Krieger Institute
Date Last Revised: 
December 5, 2013
Date Published: 
April 2, 2007

Individuals with autism often experience significant challenges in areas other than social and communication skills, and repetitive behaviors and obsessions. These issues include:

Unusual Sensory Experiences

People with autism often have unusual responses to sensory stimuli.1 They may be hypersensitive — that is, over-sensitive — to some of the information coming from their senses. They may find common textures, tastes, smells, noises, or lights unbearable, or they may shrink from another person’s touch. At the same time, they may be hyposensitive — that is, under-sensitive — to other stimuli, or sometimes even to the same ones.2 Noise can be experienced as so nerve wracking that a child claps his hands over his ears and retreats into a closet, or noise can be utterly ignored to such an extent that a child with intact hearing appears deaf. It is part of the perplexing puzzle of autism.

In many studies, children with autism have been shown to experience such sensory issues much more often than either typically developing children or children with developmental issues other than autism.3,4,5 Unusual sensory experiences can therefore serve as a “red flag” for the disorder.

In its definition of autism, the 2013 edition of the psychiatric diagnosis manual includes sensory problems as an example of a restricted and repetitive behavior of autism.

See Challenging Behaviors: Sensory Issues

Intellectual Disability

Some people with autism also have intellectual disability. Although it was once believed that 70-80% of those with autism had intellectual disability, it is now believed that the number is much lower. That is partly because people with milder forms of autism have been included in the autism spectrum disorder category, and partly because of developmental gains made due to better early intervention.6

When there is intellectual disability, it can range from mild to profound.7 Whatever degree is present, it will complicate both assessments and interventions. For parents and other day-to-day caregivers, it can make things that much harder, pushing developmental milestones – such as dressing oneself, self-feeding, and toileting — out to later ages.

Read IAN Research Report #2 to learn what families participating IAN Research — the nation's largest online autism research project — are telling us about their children, intellectual disability and IQ.

Seizures

A significant minority of individuals with autism also have epilepsy. The precise prevalence rate for this is not known, although various studies have placed it somewhere between 5 and 46%.8 Epilepsy, which is defined as two unprovoked seizures, begins to occur most often in people with autism either before 5 years of age or after 10 years of age, but it may begin at any time. Epilepsy in autism is associated with intellectual disability, and those with normal or near-normal intelligence have a low risk of developing it.9 “Epilepsy,” writes one researcher, “should be routinely investigated in individuals with autism because it is relatively common, especially in clinical and age-defined sub-groups.” 10

See The Epilepsy Connection: Why are People with Autism at Risk?

Regression

Although most children with autism are socially different from birth, there is a subset who develop normally, or nearly so, achieving expected developmental milestones and learning a few words until, usually between the ages of 18 and 20 months, language progress stalls, words once known are lost, and the desire to relate socially declines.11 It has been claimed that approximately 25% -30% of individuals with autism have experienced regression.12,13 However, recent studies indicate that the percentage may actually be somewhat lower.14,15 This finding of fewer cases could be due to increased awareness of symptoms that occur at much younger ages. Such symptoms might have been overlooked in an earlier era, such that many cases of autism were called "regressive" when they in fact were not.

Read IAN Research Report #6 to learn what families are telling us about their children with ASD and regression.

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References: 
  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author. (Pg. 72)
  2. Baranek, G.T., (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32(5), 397-422.  Abstract
  3. Kientz, M.A., & Dunn, W. (1997). A comparison of the performance of children with and without autism on the Sensory Profile. American Journal of Occupational Therapy, 51(7), 530-537.  Abstract
  4. Rogers, S.J., Hepburn, S., & Wehner, E. (2003). Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33(6), 631-642.  Abstract
  5. Baranek, G.T., Fabian, J.D., Poe, M.d., Stone, W.L., & Watson, L.R. (2005). Sensory experiences questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. Journal of Child Psychology and Psychiatry, 47(6), 591-601.  Abstract
  6. Shea, V., & Mesibov, G. (2005). Adolescents and adults with autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.288-311). Hoboken, NJ: John Wiley & Sons. (pg. 291)
  7. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author. (Pg. 71)
  8. Spence, S.J. Schneider, M.T. (2009) The role of epilepsy and epileptiform EEGs in autism spectrum disorders. Pediatr Res. 2009 Jun;65(6):599-606. View abstract.
  9. Minshew, N.J., Sweeney, J.A., Bauman, M.L., & Webb, S.J. (2005). Neurological aspects of autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.473-514). Hoboken, NJ: John Wiley & Sons. (pg. 502)
  10. Canitano, R. (2007). Epilepsy in autism spectrum disorders. European Child and Adolescent Psychiatry, 16(1), 61-66.   Abstract
  11. Chawarska, K., & Volkmar, F. (2005). Autism in infancy and early childhood. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.223-246). Hoboken, NJ: John Wiley & Sons. (pg. 224)
  12. Tuchman, R.F., & Rapin, I. (1997). Regression in pervasive developmental disorders: Seizures and epileptiform electroencephalogram correlates. Pediatrics, 99(4), 560-566.  Abstract
  13. Lord, C., Shulman, C., & DiLavore, P. (2004). Regression and word loss in autistic spectrum disorders. Journal of Child Psychology and Psychiatry, 45(5), 936-955.  Abstract
  14. Siperstein, R., & Volkmar, F. (2004). Brief report: Parental reporting of regression in children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 34(6), 731-734.  Abstract
  15. Fombonne, E., & Chakrabarti, S. (2001). No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics, 108(4), e58.  Abstract