Tag Archives: sensory integration

Body

Interoception

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Understanding Interoception in Autism and ADHD

Interoception is a lesser-known but crucial aspect of sensory processing that refers to how individuals perceive internal bodily sensations, such as hunger, thirst, and the need to use the restroom. This sensory domain is integral to how we understand and respond to our body’s needs. For individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), challenges with interoception can significantly impact daily functioning and self-regulation. This article delves into the complexities of interoception, its neural underpinnings, and its presentation in individuals with ASD and ADHD, highlighting the importance of understanding and accommodating these sensory processing challenges.

1. What is Interoception?

Interoception involves the brain’s processing of signals from inside the body, enabling the perception of physical states like hunger, pain, and temperature. These signals are processed by various brain regions, including the insular cortex, which plays a key role in mapping internal states and making this information conscious.

2. Interoception in the Brain

The brain’s processing of interoceptive signals is intricate. For most people, these signals help regulate bodily functions automatically. However, in individuals with neurodevelopmental disorders such as ASD and ADHD, these signals can be misinterpreted or not perceived clearly. This miscommunication can be due to differences in how their brains are wired and how sensory information is integrated.

3. Presentation in Autism and ADHD

In the context of ASD and ADHD, difficulties with interoception can manifest in various ways. For instance, an individual may not recognize they need to use the bathroom until the need is urgent, leading to accidents. They might also struggle with recognizing when they are hungry or full, which can lead to irregular eating patterns and discomfort.

4. The Impact of a Busy Brain and Faulty Sensory System

For those with ASD and ADHD, the constant buzz of a busy brain can overshadow subtle interoceptive cues until they become overwhelming. This can lead to sudden and intense manifestations of basic needs, such as a sudden urgency to urinate or extreme hunger late at night. These are not acts of defiance or poor self-control, but rather symptoms of their sensory processing challenges.

5. The Role of Schedules and Routines

Implementing structured schedules and routines can help manage these interoceptive signals by providing external cues that remind the individual to attend to their needs. Regular reminders for meals, bathroom breaks, and other necessities can greatly assist in daily functioning and reduce incidents like bed-wetting or late-night eating.

Conclusion

Understanding interoception and its challenges in individuals with ASD and ADHD is essential for caregivers and educators. It is crucial to approach these challenges with empathy and support, rather than punishment or shame. By establishing supportive routines and being mindful of their unique sensory needs, we can help individuals with ASD and ADHD navigate their world more comfortably. Remember, while they are capable of self-care, the support from caregivers who understand and anticipate their needs can make a significant difference in their quality of life.

Autism

Autism Early Intervention

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Overview of Autism Early Intervention

Autism Early Intervention refers to the application of targeted strategies and therapies designed to aid in the development of young children diagnosed with autism spectrum disorder (ASD). The interventions aim to address developmental delays in areas such as communication, social skills, and cognitive and motor skills, typically starting before the age of three, which is considered a critical period in a child’s neural development.

History and Development

The formal notion of early intervention emerged significantly in the latter half of the 20th century, influenced by broader advances in developmental psychology and early childhood education. Prior to this, children with developmental delays often received little to no specialized support. The recognition of the importance of early brain development catalyzed research into targeted interventions for children with ASD.

Steps to Access Early Intervention Services

  1. Early Identification: The process typically begins with early identification or screening. Pediatricians or early childhood care providers might use developmental screening tools during regular check-ups when a child is between 18 to 24 months old.
  2. Formal Diagnosis: If a child shows potential signs of ASD, they are referred for a more comprehensive evaluation. This evaluation is necessary for a formal diagnosis and is usually conducted by a team of specialists that might include psychologists, neurologists, and psychiatrists.
  3. Development of an Individualized Plan: Once diagnosed, a tailored intervention plan is developed. This plan is based on the individual needs of the child and often involves input from various specialists, including speech therapists, occupational therapists, and special educators.
  4. Implementation of Interventions: The intervention itself can be delivered in various settings, including the child’s home, daycare, or a specialized early intervention center. Interventions are frequently adjusted based on the child’s progress and evolving needs.
  5. Regular Monitoring and Adjustment: Continuous assessment is integral to early intervention. Progress is regularly monitored, and interventions are adjusted as necessary to suit the child’s developmental trajectory.

Common Therapies and Interventions

  • Behavioral Therapies: Applied Behavior Analysis (ABA) is the most widely known and researched therapy. It involves structured techniques to encourage positive behaviors and reduce undesired ones.
  • Developmental, Individual Differences, Relationship-Based Approach (DIR/Floortime): This method focuses on building healthy foundations for social, emotional, and intellectual capacities rather than solely on skills and isolated behaviors.
  • Speech and Language Therapy: These therapies address challenges with communication, including speech, comprehension, and non-verbal communication skills.
  • Occupational Therapy: Focused on improving daily living skills and motor skills, helping the child to become more independent.
  • Physical Therapy: Aimed at enhancing motor skills and physical strength.
  • Social Skills Classes: Designed to improve interaction skills and the ability to form relationships.

Global Participation

Countries worldwide participate in autism early intervention, though the availability and nature of services vary significantly. High-income countries typically have more structured programs and resources available. Many low- and middle-income countries are still in the process of developing adequate services and often rely on non-governmental organizations and international aid for support.

Conclusion

Autism early intervention is a comprehensive, multidisciplinary approach designed to address the diverse needs of children with ASD. The effectiveness of these interventions can vary, and they are most beneficial when tailored specifically to the individual’s needs and started at an early age.

Editorial

Autistic Females

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Translating Brain Activity: Insights into Autism Spectrum Disorders in Females

This discussion is a translation and interpretation of the findings from the journal article:

Xie J, Zhang W, Shen Y, Wei W, Bai Y, Zhang G, Meng N, Yue X, Wang X, Zhang X, and Wang M (2023). Abnormal spontaneous brain activity in females with autism spectrum disorders. Front. Neurosci. 17:1189087. doi: 10.3389/fnins.2023.1189087

Frontiers | Abnormal spontaneous brain activity in females with autism spectrum disorders

ObjectivesTo date, most studies on autism spectrum disorder (ASD) have focused on sample sets that were primarily or entirely composed of males; brain sponta…

For much of my life, I navigated a world that often felt bewilderingly out of sync with my experiences. It was as if I were constantly trying to decipher a language I only partially understood, struggling to piece together cues and contexts that seemed to come naturally to others. This persistent sense of being an outsider in my own life led me on a quest for answers—a quest that, at the age of 46, culminated in a diagnosis of autism spectrum disorder (ASD).

In retrospect, the scientific insights into the brain activity of females with ASD, detailed in the journal article referenced, illuminate aspects of my own experiences with startling clarity.I hope you find it interesting as well. Below are the brain regions this journal article referenced and how they would present daily.

  1. Left Superior Temporal Gyrus (STG) – Enhanced Activity:
    • Life Example: A young woman with ASD might be particularly sensitive to sounds, finding even the hum of a refrigerator or distant conversations to be overwhelming. While in a café, the blend of music, chatter, and the espresso machine might make it challenging for her to focus on her friend’s words during a conversation. This heightened auditory processing could be tied to the increased activity in her left STG.
  2. Left Superior Frontal Gyrus (SFG) – Decreased Activity:
    • Life Example: When planning a group project, a female student with ASD might struggle with organizing the tasks and deciding the roles for each member. She may have a clear vision of the project’s end goal but find it challenging to break down the steps and delegate, reflecting difficulties associated with decreased activity in her left SFG, which affects planning and decision-making.
  3. Left Middle Occipital Gyrus (MOG) – Decreased Activity:
    • Life Example: During an art class, a girl with ASD may have trouble interpreting abstract paintings. While others discuss the emotions conveyed through the chaotic brushstrokes and color choices, she might focus on the individual elements without integrating them into a cohesive emotional narrative, relating to the decreased activity in the left MOG involved in visual processing.
  4. Bilateral Superior Parietal Lobule (SPL) and Bilateral Precuneus – Decreased Activity:
    • Life Example for SPL: A woman with ASD might find navigating a crowded market challenging. Keeping track of directions while processing the multitude of shop signs and avoiding bumping into people could be overwhelming, illustrating the role of the SPL in spatial orientation and sensory integration.
    • Life Example for Precuneus: A girl with ASD may struggle to recall personal experiences when asked to share a memory in class. She can remember facts but may have difficulty vividly re-experiencing past events or imagining future scenarios, reflecting the involvement of the precuneus in episodic memory and self-processing.
  5. Correlation with Social Responsiveness Scale (SRS) Scores – Right Precuneus:
    • Life Example: A teenager with ASD may be misunderstood by her peers due to her unique way of expressing interest and affection. She might not engage in typical social banter but shows her care by remembering intricate details about her friends’ preferences. This sincere but atypical social communication, correlating with changes in the right precuneus, might not always be recognized by others, impacting her social interactions and friendships.

In conclusion, the variability in brain connectivity, particularly within the Default Mode Network (DMN) and related networks, underscores the complexity of autism spectrum disorders (ASD). This variability manifests in both hypo-connectivity (reduced connectivity) and hyper-connectivity (increased connectivity) within different regions of the brain, contributing to the diverse cognitive and sensory experiences of individuals with ASD. These findings suggest that the traditional view of ASD as simply a disorder of social skills is incomplete. Instead, ASD involves a broad array of neurodevelopmental variations that affect not only social interaction but also sensory processing and cognitive function. Understanding these neural underpinnings is crucial for developing more effective personalized interventions and supports that address the specific needs and experiences of individuals with ASD.

Zhang, Y., Li, N., Li, C. et al. Genetic evidence of gender difference in autism spectrum disorder supports the female-protective effect. Transl Psychiatry 10, 4 (2020). https://doi.org/10.1038/s41398-020-0699-8

Hull, L., Petrides, K.V. & Mandy, W. The Female Autism Phenotype and Camouflaging: a Narrative Review. Rev J Autism Dev Disord 7, 306–317 (2020). https://doi.org/10.1007/s40489-020-00197-9