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Sensory Processing in Autism and the

built environment
Teresa Tavassoli
Autism Research Centre
University of Cambridge
&
Andrew Brand
Royal College of Art
H l Hamlyn
Helen
H l Centre
C t
NAS 2011

Acknowledgements
Manythanksto:
Allparticipantsfortakingpartinourstudiesand
everyoneintheARC,especiallyJillianSullivan,
y
p
y
BonnieAuyeung,BhismadevChakrabartiand
SimonBaronCohen!TothePinsentDarwinTrust
andAutistica.
Formoreinformationvisit:
www.autismresearchcentre.com
Oremailme:
tt303@cam.ac.uk

Overview
1. Anecdotal reports of sensory issues in Autism Spectrum
Conditions (ASC)
(
)
2. Questionnaire-based sensory studies in ASC at the Autism
Research Centre
3 People-centred
3.
P l
d design
d i researchh off sensory sensitivities
i i i i in
i ASC
4 Applied
4.
A li d researchh off sensory sensitivities
iti iti andd the
th built
b ilt
environment

1 Autism Spectrum Conditions


1.
Diagnostic criteria
1 Qualitative impairment in social interaction
1.
2. Qualitative impairments in communication
3. Restricted, repetitive and stereotyped behaviour
In addition

1 Anecdotal reports
1.
A
Anecdotal
d l reports suggest unusuall perceptuall processing
i may
lie at the core of ASC.
FromasfarbackasIcan
remember,Ialwayshatedtobe
huggedItwaslikeagreatall
engulfingtidalwaveof
stimulation[]Myhearingislike
havingasoundamplifierseton
maximumloudness.

TempleGrandin(2008)

1 Anecdotal reports
1.
Reports demonstrate the variety and complexity of sensory
symptoms in ASC
Variety of sensory issues:
Over the years I have observed that sensory sensitivities in
autism are highly variable. One child will love to play with
running water, and another autistic child will run away and
scream when a toilet fflushes(Grandin,
(
1996).
)
Link to social and communication issues:
A a child,
As
hild I was so overwhelmed
h l d by
b all
ll the
h visual
i l details,
d il all
ll
the auditory details, that I find it unsurprising that I missed
social cues and failed to develop social and communication
skills
k ll (G.,
( Communication, 2010).
)

Overview
1. Anecdotal reports of sensory issues in Autism
Spectrum Conditions (ASC)
2. Questionnaire-based sensory studies in ASC at the
Autism Research Centre
3 People-centred
3.
P l
t d design
d i researchh off sensory
sensitivities in ASC
4. Applied
pp
research of sensoryy sensitivities and the built
environment

2 S
2.
Sensory Q
Questionnaires
ti
i
Sensory questionnaires (Sensory Profile, Sensory Sensitivity
Q
Questionnaire)
i
i ) have
h
been
b
usedd to study
d perception
i in
i ASC andd
show sensory abnormalities in children and adults with autism
(Leekman et al,
al 2007).
2007)
Most studies have been conducted with children.
children
Studies at the Autism Research Centre (ARC)
Study 1: Sensory Profile in ASC
St d 2: Sensory
Study
Sensor Over-Responsivity
O er Responsi it Scale in ASC

2 The Sensory Profile in ASC


2.The

The Sensory
Th
S
Profile
P fil is
i a widely
id l usedd
sensory questionnaire.

The Sensory Profile shows sensory


differences in over 90 % of children
and adults with ASC (Kientz &Dunn,
&Dunn
1997; Tomcheck & Dunn) and crossculturally (Chen et al, 2009).

Sensory Profile scores have been


p
behaviours ((Chen
linked to repetitive
et al, 2009), stress levels (Corbett et
al, 2009)and skin conductance.

2 Sensory Profile
2.
Neurological
g
Threshold

Behavioural Response
p
Acting in ACCORDANCE Acting to COUNTERACT
with threshold
threshold

High
(less sensitive)

1) Poor/Low Registration 2) Sensation Seeking


II add spice to my food
food
II do not notice when
people come into the
room
room

Low
(more sensitive)

3) Sensitivity to Stimuli
I am bothered by fast
moving stimuli

4)Sensation Avoiding
I leave to another room
when I smell a strong
odor
SensoryProfileManual,WinnieDunn

2. Study at the ARC:


Sensory Profile in ASC
Aim
To compare self-reported sensory experiences of adults with and
without
ith t ASC
Method
M
h d
Adolescence/Adult Sensory Profile
A 60-item self-report questionnaire assessing levels of sensory
processing in everyday life.
Scores
S
were calculated
l l t d for
f the
th following
f ll i subscales:
b l
Low Registration, Sensation Seeking, Sensory Sensitivity and
Sensory Avoiding
Avoiding.

2. Study:
Sensory Profile in ASC
ParticipantswerematchedforIQ(WASI),ageandgender
P ti i
t
t h d f IQ (WASI)
d
d

Characteristics

ASC Group
(n= 23)

Control group
(n=27)

Sex ratio (f: m)

11:12

14:13

Avarage Age in years


(SD)

35.8 (12.5)

28.1 (6.8)

Full scale IQ (SD)

114.6 (17.1)

114.7 (10.2)

113.1 (19)

115.6 (9.7)

108.1 (16.1)

110.1 (9.1)

Performance IQ (SD)
Verbal IQ (SD)

IQ=IntelligenceQuotient,SD=standarddeviation

2 Study: Sensory Profile in ASC


2.
Results: AdultswithASCreportedmoreLowRegistration,SensorySensitivities,
S
SensoryAvoidingandless
A idi
dl
S
SensationSeeking(p<.001).
ti S ki ( < 001)

ASC
Mean score (SD)

Control
Mean score (SD)

Low Registration
(24-35 are in the average range)

39.2 (8)

30.8 (7)

Sensory Sensitivities
(26-51 in the average range)

47.6 (6)

39 (8)

Sensory Avoiding
(27-41 are in the average range)

50 7 (8)
50.7

37 (6)

Sensation Seeking
(43 55 are in the average range)
(43-55

37.3 (8)

50 (5)

2 Study: Sensory Profile in ASC


2.
Result: ThedistributionofSensoryQuadrantsdiffersbetweenthe
groups(Chisquare=26,p=.0001).

ASC

Control

Lo Registration
Low

10%

0%

Sensation Seeking
g

5%

76%

Sensory Sensitivities

30%

11.5%

Sensory Avoiding

55%

11.5%

2. Study at the ARC:


Sensory Over-Responsivity Scale (SenSOR)
The SenSOR Inventory was developed to
evaluate sensory processing disorder, more
narrowly sensory overresponsivity (Schoen &
Miller, 2009).
Sensory Processing Disorder (SPD, formerly
known as "sensory integration dysfunction") is a
condition that exists when sensory signals don't
get organized into appropriate responses.
Formoreinformation:http://www.spdfoundation.net/

2 Sensory Processing Disorder


2.
and ASC
1in20childrenshowssensoryprocessingdifficulties(Ahn
yp
g
(
etal,,
2004).
Nearly80%ofchildrenwithASCshowSensoryProcessing
Nearly 80 % of children with ASC show Sensory Processing
difficulties(SPD)(Miller&Fuller,2006).
However,fewerchildrenwithSPDhaveASC.
However fewer children with SPD have ASC

ASC

SPD

Study
y 2: Sensoryy Over-Responsivity
p
y Scale
(SenSOR) in ASC
The SenSOR Inventory was developed to evaluate overresponsiveness to sensory stimuli (Schoen & Miller, 2009).
Individuals with SOR respond to stimulation faster and with
more intensity/duration (Miller et al, 2007).
Example
E
ample items:
These tactile sensations bother me
Labels, mud, glue etc
These visual sensations bother me
brightly colored materials (e.g. clothes), fluorescent lights
Formoreinformation:http://www.spdfoundation.net/

Study 2: SenSOR in ASC


Participants
277 adults with ASC were compared to
268 control participants
Method
M
th d and
d materials
t i l
SenSOR Inventory (tactile, visual, etc)

Autism Spectrum Quotient (AQ): I tend to notice details

Raven progressive matrices

Study 2: SenSOR in ASC


Results: Adults with ASC differ from control participants on the
SenSOR overall, and had higher scores on all subscales including
touch vision
touch,
vision, sounds,
sounds movement and smell items (p<.0001).
(p< 0001)
ASC

Control

Differ?

SenSOR

26 (15)

16 (12)

p (<.01)

Touch

8 ((4))

5 ((3))

p ((<.01))

Vision

2 (1)

1 (1)

p (<.01)

Smell

2 ((2))

1 ((1))

p ((<.01))

Hearing

8 (4)

5 (3)

p (<.01)

Movement

3 (2)

1 (1)

p (<.01)

Taste

2 (1)

2 (1)

p (<.01)

Study 2: SenSOR in ASC


Results: The SenSOR score was ppositively
y correlated to the
AQ across groups (r=.60, p<.0001), and also within the ASC
(r=.54, p<.0001) and control group (r=.44, p<.0001).

S
Summary
so ffar
Ad
Adults
l with
i h ASC showed
h
d diff
differences on all
ll
subscales of the Sensory Profile and reported
y, more avoidance of
more sensoryy sensitivity,
sensory stimuli, lower registration of
sensations and less sensation seeking.
Adults with ASC report more sensory overresponsivity to sensory stimuli in touch,
touch vision,
vision
hearing, smell, taste and movement.
There was a positive link between the amount
of sensitivity reported and autistic traits.

What can we learn from this?


Modify
M
dif the
th environment
i
t att home
h
andd in
i schools
h l
- Sensory rooms at home or in schools: to stimulate and develop
the sensoryy system
y
- Separations in the classroom
- Soundproof rooms
- Use
U off sensory toys
- More information can be find on:
1 www.autism.org.uk
1.
www autism org uk (NAS homepage)
2. www.annatullemans.com
3. Livingg in the Community:
y
Housing design for adults with Autism
Find out for each individual what is best!

www hhc rca ac uk/2988 3019/all/1/Living in the Community aspx


www.hhc.rca.ac.uk/29883019/all/1/LivingintheCommunity.aspx

AndrewBrand
ResearchAssociate2009/2010

LivingintheCommunity
Housingdesignforadultswithautism

Whatisdesign?

Whatisdesign?

Whatisdesign?

Failearlytosucceedsooner

Design:GraemeDavies,PhillipGreer,ChristopherHuntleyandLisaStroux

Designresearch=
designpractice

+peoplecentredapproach

Whatactionsormodifications
shouldbetakenintoaccountto
makebuildingsautismfriendly?
k b ildi
i f i dl ?
Project Brief September 2009
ProjectBrief,September2009

ourprocess

October2009

January2010

01
Explore

02
Focus

03
Develop

04
Deliver

Understandcontext
Understand
context
Designtheresearch

Identifyneeds
Identify
needs
Maptheinsights

Generateconcepts
Generate
concepts
Seekfeedback

Build resources
Buildresources

March

April

July

September

ourprocess

October2009

January2010

01
Explore

02
Focus

03
Develop

04
Deliver

Understandcontext
Understand
context
Designtheresearch

Identifyneeds
Identify
needs
Maptheinsights

Generateconcepts
Generate
concepts
Seekfeedback

Build resources
Buildresources

ExpertReferenceGroup

March

April

July

September

expertreferencegroup

drawingbyCharlie
youngadultwithautism
d lt ith ti

an estimated

340,000 adults require daily support

3,000 places in specialist autism services

Harker M, King N. Tomorrows Big Problem: Housing Options for People with Autism. The National Autistic Society (2004)

grouphomeforadultswithautism
h
f
d lt ith ti

Visitstosupportivelivingresidences

sketchesfrombrainstormingworkshop

designthemes

Circulationspace
p

KatieGaudion,AndrewBrand
ResearchAssociates2010/11

Senseable
Designforadultswithautism

Theprincipalaimoftheresearchisto
generatemethodsthatwillhelpadultswith
autismtomanagetheirrelationshipswith
theirhomeenvironmentsmoreeffectively,
and enhance social interaction and
andenhancesocialinteractionand
communication.

Sensation
Perception

BBefore

After

nextsteps
p
developatoolkit fordesignersandserviceprovidersthat
helps them to understand the sensory perceptual
helpsthemtounderstandthesensoryperceptual
differencesofindividualswithautism.
verifyandtranslatesensoryperceptualdifferencesinto
designoutcomesintheformofguidance,conceptsand
prototypesfor
[1]MultiSensoryRoomsincludingsensoryprops
[1]
Multi Sensory Rooms including sensory props
[2]outdoorspaces
[ ]
[3]transitionalspacessuchascorridorsandthresholds
p
ininteriordesign.

www.hhc.rca.ac.uk

www squease co uk
www.squease.co.uk

SqueaseisaninflatableDeep
Pressurevestthatzipsinsidea
p
fashionablehoodedtop.
Thevestsimulatesahuglike
pressureevenlyacrossthe
upperbodyandcanhelpthe
wearertobecomecalmerand
improvetheirconcentration.

Thankyou