Sensory processing disorder (SPD), once known as sensory integration dysfunction, refers to a condition in the brain in which cells experience difficulty receiving and responding to information that is obtained through the senses. The way in which the nervous system receives sensory messages and then turns those messages into appropriate corresponding actions and behaviors is referred to as sensory processing. When an individual’s nervous system is not able to appropriately turn sensory messages into correlating actions or behaviors, they are likely to be suffering from SPD. While everyone can experience occasional difficulties with appropriately processing information received by the senses, for people with sensory processing integration disorder, such difficulties are chronic and cause disruptions in many aspects of their daily lives. Some individuals with SPD will struggle with processing only one sense, while others will struggle with processing multiple senses.

There are two main types of sensory processing disorders that children and adults experience. Sensory issues are usually defined as either:

hypersensitivity (over-responsiveness) to sensory stimuli

or

hyposensitivity (under-responsiveness) to sensory stimuli.

Signs of sensory processing hypersensitivities (over-responsiveness):

• Extreme response to or fear of sudden, high-pitched, loud, or metallic noises (flushing toilets, clanking silverware, etc.)

• May notice or be distracted by background noises that others don’t seem to hear

• Fearful of surprise touches

• Avoids hugs and cuddling even with family or friends

• Stressed out in large crowds

• Avoids standing in close proximity to others

• Reacts as if in pain by sudden touch or sound or smells

• Fearful of fair rides and fast or spinning movement

• Extremely fearful of climbing or falling, even when there is no real danger

• Has poor balance and may fall often

Signs of sensory processing hyposensitivities (under-responsiveness):

• A constant need to touch people or textures, even when it’s inappropriate to do so

• Doesn’t understand personal space Clumsy and uncoordinated movements

• Extremely high pain tolerance

• Often harms others and/or pets when playing (i.e. doesn't understand their own strength)

• May be very fidgety and unable to sit still

• Enjoys movement-based activities like spinning, jumping, etc.

• Seems to be a "thrill seeker" and can be dangerous at times

To ‘mask’ or to ‘camouflage’ means to hide or disguise parts of oneself in order to better fit in with those around you. It is an unconscious strategy all humans develop whilst growing up in order to connect with those around us.

However, for us autistic folk the strategy is often much more ingrained and harmful to our wellbeing and health. Because our social norms are different to others around us, we often experience greater pressure to hide our true selves and to fit into that non-autistic culture. More often than not, we have to spend our entire lives hiding our traits and trying to fit in, even though the odds of appearing ‘non-autistic’ are against us.

Masking may involve suppressing certain behaviours we find soothing but that others think are ‘weird’, such as stimming or intense interests. It can also mean mimicking the behaviour of those around us, such as copying non-verbal behaviours, and developing complex social scripts to get by in social situations.

However, just because a coping strategy was once useful, it doesn’t mean it always will be. Studies are now beginning to find how detrimental to our mental health masking can be (Bradley et al., 2021; Hull et al., 2019). Autistic people who mask more show more signs of anxiety and depression and the strategy can even be linked to an increase in suicidal behaviours (Cassidy et al. 2018).

There are several reasons why this could be. Masking uses up vital resources that we can’t use in other areas of our lives. It is exhausting, which can trigger autistic ‘burnt out’ and periods of mental health crisis from the strain of trying to adapt to live in a world that just isn’t adjusted to your way of thinking.

Masking also stops us from developing our true identities. The pressure to fit in means we rarely have time or energy to do the things we want to do or to behave like our true selves. In severe cases, an individual who has been masking their entire life may develop a dissociative identity disorder or a personality disorder from the trauma and repression of the development of their “true self” in childhood.

Because masking often involves hiding and repressing stimming, a masked Autistic individual may feel incredibly emotionally and sensorily dysregulated and detached.

Autistic masking and unmasking will look different for everyone. Autistic masking may be choosing not to stim in public, forcing eye contact, or pretending to laugh at something that others find funny. For some, it means discouragement from pursuing interests not deemed ‘socially acceptable’ or feeling pressured to always be agreeable, bubbly, and energetic (or feeling pressured to repress your bubbly attitude or energy)

EXAMPLES OF UNMASKING AUTISM:

• Freely stimming in public.

• Avoiding eye contact that feels uncomfortable.

• Giving yourself permission to be blunt and direct.

• Explaining to others when you need to leave a social situation with no shame.

• Responding genuinely to a question instead of overthinking about what the ‘correct’ response should be.

• By telling others about sensory needs.

The cerebellum—which means ‘little brain’ in Latin—constitutes only 10 percent of the brain’s total volume, though it contains 80 percent of all neurons in the human brain. It was once thought that this irregularly shaped structure of the brain primarily governed motor function, but recent studies found that it also plays an important role in implicit learning (extracting the underlying rules without explicit instruction) as well as sensory, and cognitive functions (including attention and language), executive functions, as well as affective regulation, and regulating fear and pleasure responses. The cerebellum is important for making postural adjustments in order to maintain balance. The cerebellum forms multiple closed-loop circuits with cerebral cortical regions that underpin movement, language, and social processing. Through its input from vestibular receptors and proprioceptors, it modulates commands to motor neurons to compensate for shifts in body position or changes in load upon muscles.

Structural MRI studies in ASD patients described a reduction in the size of several regions of the cerebellum including the vermis, particularly the lobules VI and VII

Further findings included an enlargement in cerebellar white matter volume and a reduction in the grey/white matter ratio

Your cerebrum is the largest part of your brain, and it handles a wide range of responsibilities. The cerebrum has two hemispheres (or halves) Located at the front and top of your skull, it gets its name from the Latin word meaning “brain.” It controls movement, speech, intelligence, emotion, and what we see and hear.

The cerebrum is instrumental in everything you do in day-to-day life, ranging from thoughts to actions. In essence, it’s responsible for the brain functions that allow us to interact with our environment and make us who we are.

Your cerebrum is the largest part of your brain and includes parts above and forward of your cerebellum. Your cerebrum is the part of your brain that starts and manages conscious thoughts; meaning, things that you actively think about or do.

Brain changes in autism are comprehensive throughout the cerebral cortex rather than just particular areas thought to affect social behavior and language, according to a new UCLA-led study that significantly refines scientists’ understanding of how autism spectrum disorder (ASD) progresses at the molecular level.

Interoception is a lesser-known sense that helps you understand and feel what's going on inside your body. It is the body's ability to recognize and interpret its own internal cues, such as hunger, thirst, exhaustion, and pain.

Interoceptive accuracy is A term that describes how good we are at feeling signals from the body, for example: how good you are at feeling your heart beating.

Interoceptive attention is a term that describes how often we feel these signals, for example: how often you notice your heart beating.

Interoception includes all the signals from your internal organs, including your cardiovascular system, your lungs, your gut, your bladder and your kidneys. Much of the processing of these signals takes place below conscious awareness: you won’t be aware of the automatic feedback between brain and body that helps to keep your blood pressure level, for instance, or the signals that help to stabilize your blood sugar levels. But many of these sensations – such as tension in your muscles, the clenching of your stomach, or the beating of your heart – should be available to the conscious mind, at least some of the time. And it may affect the ways you read and interpret those feelings.

This idea stems from the work of Prof Antonio Damasio at the University of Southern California in the 1990s. He proposed that emotional events begin with non-conscious changes in bodily states, called “somatic markers”:(Somatic markers" are feelings in the body that are associated with emotions, such as the association of rapid heartbeat with anxiety or of nausea with disgust. According to the hypothesis, somatic markers strongly influence subsequent decision-making) when you see an angry dog, for instance, your muscles tense or your heart begins to race. This physiological reaction occurs before you are even aware of the emotion, and it is only when the brain detects the alteration to the body’s internal state, through interoception, that we actually experience the feeling and allow it to shape our behavior. Without the back-and-forth between the brain and the body, the feelings of happiness, sadness or excitement wouldn’t exist.

Regardless of age, the development of interoception can slow down or even stop for autistic people. It is not known why this happens, although it may be due to a self-protection mechanism associated with trauma. Many autistic people experience trauma, and this may halt or lower their interoceptive awareness. Masking is another highly probable cause of this phenomenon.

(an example of this might be, not feeling joy or excitement because you’re masking the stims that you would normally do to regulate and engage your emotional signals. This would be similar to years of pent-up blockages, such as if someone never allowed themselves to cry and release that energy. The signal may eventually stop as a result of repressing it, but the side effects on the body and mind continue to build up.)

Prof Hugo Critchley at Brighton and Sussex Medical School points out that poor interoceptive awareness can also lead to the sense of “depersonalization” and dissociation, which are early symptoms of trauma responses that can further lead to complex personality or dissociative disorders. Interoception helps us to form our most basic sense of self, and it seems to be askew in these circumstances.

When asking for support with chronic stress or mental health difficulties as an Autistic person, it is important to assess your interoceptive abilities and address these, as well as support your mental well-being and address unmasking. They can evaluate an adult’s interoceptive awareness using the Interoception Sensory Questionnaire (ISQ) (Fiene, Ireland & Brownlow, 2018), or a shorter questionnaire, such as Goodall’s Interoception Evaluation and Support Plan (Goodall, 2022).

(Validation of the interoceptive accuracy scale (IAS))

These tools evaluate an individual’s interoceptive awareness over a number of areas. When attempting to evaluate our own or someone else’s interoceptive awareness, it is not appropriate to ask ‘do you know when you feel hot?’ as many people will say ‘yes’, regardless of their interoceptive awareness. Instead, they should be asked ‘how do you know when you feel hot?’ or ‘what signals does your body show you (or make) so that you know when you are getting hot?’ If someone does not yet have a basic level of interoceptive awareness, then this needs to be developed before they focus on their emotional awareness.

There is a large range of comorbidities, including gastrointestinal disorders and mental and neurological diseases.

Common underlying medical conditions include:

• Anxiety

• Depression

• Epilepsy

• Gastrointestinal and immune function disorders

• Metabolic disorders

• Sleep disorders

• Seizures

• ADHD

• Sensory Processing Disorders

• Bipolar disorder

• There is strong evidence for the existence of a high comorbidity between autism and psychosis with percentages reaching up to 34

  • Differential diagnosis, comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder (ASD). Findings of most studies support that ASD in high-functioning adults is associated with a distinct personality profile even if variability exists. Cluster A and cluster C personality disorders (PD) are the most frequent co-occurring PD in ASD, but overlapping features should be considered.

Autistic meltdowns and shutdowns are both behavioral responses to feeling overwhelmed, overly frustrated, tired, and/or experiencing sensory overload. The difference between the two is that meltdowns are outward, and shutdowns are inward responses or behaviors.

A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses control of their behavior. This loss of control can be expressed verbally (eg shouting, screaming, crying), physically (eg kicking, lashing out, biting), or both ways.

A meltdown is not the same as a temper tantrum. It is purposeful or manipulative behavior. When a person is completely overwhelmed and feels as if the world is imploding, it is understandable that the result is a meltdown.

Many autistic people will show signs of distress before having a meltdown, which is sometimes referred to as the “rumble stage”. They may start to exhibit signs of anxiety such as pacing, seeking reassurance through repetitive questioning, or physical signs such as rocking or becoming very still. At this stage, there may still be a chance to prevent a meltdown. Strategies to consider include, diversion, using calming strategies such as stimming or listening to music, removing any potential triggers, and deep breathing.

If a meltdown cannot be prevented, make sure you are in a safe space and are able to let the energy out without harming yourself or others - hitting a pillow, for example, is a way to prevent from hitting your leg, or gently smashing your face into your bed is a healthier way to prevent from smashing it against the wall. You may need to allow yourself to scream and stim in perceived “extreme or explosive” ways to let out the build-up of anxious energy in your system.

If After having meltdowns, you often find you have harmed yourself or broken something during the meltdown, it may be helpful to Practice self-soothing activities during the Rumble Stage and provide yourself with alternative safer ways to project the explosion of energy.

Also, if you have someone to support you, have a discussion with them over the best ways to help you personally feel safer and calmer when a meltdown is triggered, while physical restriction during meltdowns is unsafe and distressing someone on the outside could help redirect your energy (like placing the pillow for you to prevent you from hitting yourself, etc) to make sure you’re not harming yourself or breaking something you value when you feel out of control.

Shutdowns are a more muted response to extreme overload or stress. When an autistic person goes into shutdown mode, there are a few common signs. These are: Being completely silent. Not being able to communicate in any way.

Autistic shutdowns can look different from person to person. However, some of the commonalities are:

• Assuming a Monotone voice

• Staring

• Becoming unresponsive to others

• A feeling of being “far away”

• The inability to speak or move

• Robotic body movements if movement can happen at all

• A feeling of heaviness in the limbs

• Wanting to be left alone

• Difficulty forming thoughts or no thoughts at all

• No energy

• From the outside, behavior may seem unrecognizable-like you’re a different person

• Some common causes of an Autistic shutdown:

• Sensory overload

• Emotional overload

• Not having enough time to process difficult topics

• Being rushed to make a decision (feeling cornered)

• Overwhelm due to Pathological Demand Avoidance

• Stress

• Pain or illness

When a shutdown has been triggered, Allow yourself time to get to a safe space, alone or with someone that provides you comfort, where you do not need to engage or interact and can get sensorily comfortable (turning off the lights, laying with a soft stuffed animal, stimming, etc) Sleeping helps the body recharge and reset.

Neurodivergent Style Communication Examples May Look Like This:

• May not understand indirect language, preferring straightforward or direct language

• May not demonstrate “typical” joint attention (JA), such as eye contact, because it is awkward/painful,

• May not understand nuances or purpose of “small talk,” preferring to share lots of information about topics they enjoy (“info dumping”)

Whereas Neurotypical Style Communication Examples May Look Like This:

• Often use indirect language to be casual or funny, interpreting more direct language as rude

• Joint attention looks like shared gaze, eye contact, pointing to a referenced item

• Stick to “small talk” until they are comfortable with someone

  Schemas are often used in Nuerotypical communication and interactions. Research on schemas in individuals with autism has demonstrated differences in schema development between individuals in this population and those who are “typically developing”. However, schema development does not occur spontaneously but is formed along a developmental path that begins in infancy.

  Types Of Schemas

• Person Schemas: These schemas focus on particular people. For instance, we might have a schema for our mother. This schema includes information about how she looks, her behaviors, and her choices. (this can also cause dilemmas of the Me vs You mindset, Prejudice and stereotypes are prime examples. When people hold certain beliefs about a particular person or group or race, it can cause problems in looking beyond their existing schemas.)

• Social Schemas: These schemas focus on how individuals act in social situations. For example, how to behave at a social party, which includes, wearing appropriate attire, greeting people, making conversation, etc.

• Self-Schemas: These schemas focus on information and views about the self. This part includes information about the current self and idealized self. Humans continue to develop these schemas throughout their life. These schemas start developing from early childhood through the help of caregivers. They influence how we perceive ourselves, which leads to the development of schema. As and when we grow up, meet new people, and have new experiences, our schema continues to grow and alter accordingly. For example, if Sophia has a schema for being smart, she might think of herself as a smart individual.

• Event Schemas: These schemas are about how individuals should behave or act in specific contexts or situations. For instance, schemas about how to attend a lecture, how to wait in line for tickets, etc. Event schemas are also known as scripts.

  • Scripts include how to perform or behave during events or situations such as birthdays, or at a cinema hall.

• Object Schemas: These schemas focus on material objects and their use. For example, a car is a vehicle that can be used for traveling from one place to another is a schema for a car (an object).

Bottom-up processing is when sensory receptors pick up signals for the brain to integrate and process. Which is when the environment (stimuli) influences our thinking.

It’s called “bottom-up” because it begins with the external stimulus — such as a tree or the smell of cookies — and then that sensory information moves to the brain for analysis.

For instance, if you suddenly detect a sweet chocolaty smell wafting through the house, you might then determine that someone in your home is baking chocolate chip cookies.

To determine this, you didn’t need any other context or information — you simply used the sweet smell (the stimulus or raw data) to make your analysis. Your perception didn’t require prior knowledge that anyone was baking cookies.

Overall, bottom-up processing involves the following steps:

• intake of new sensory information

• sensory receptors send signals to the brain

• the brain creates a perception via these signals

“Sensation” is the bottom-up process by which our senses — vision, hearing, smell, touch, and taste — receive and relay external stimuli.

Whereas, “Perception” is the top-down mechanism that our brains use to organize and interpret data, which we put into context.

In bottom-up processing, sensation and perception are essentially the same. In other words, we perceive items via sensation — rather than with our conceptual ideas.

In top-down processing, perception and sensation are separate. First, we use context and expectations to create a holistic perception of the world, and then we start to focus on the smaller details using sensation.

You may find someone with Top-Down Processing to be always making assumptions, and looking for context to back up and support their precognitions and bias rather than paying attention to new or conflicting information in front of them.

However, with Bottom-Up processing, you may find yourself having to constantly relearn certain skills, and having to pay attention to the details of your surroundings and actions in each situation as if you were doing it for the very first time every single time.

The majority of the general population is known to learn language through Analytical Language Processing, which is how words are taught to us in school growing up. However, 80 percent of the known Autistic population processes language through a different model called Gestalt Language Processing.

Thinking back to when you were in school, you were given a handful of vocabulary words every week to memorize which are then given to you in a box above the vocabulary test at the end of the week, to have you “fill in the blank in the sentence” and teach you to use words as building blocks for the sentence. This teaching model is based on Analytical processing. language. When an Analytical Processor is very young, they are taught to build speech up from the words they use. A little kid may say “play!” or “park!” over and over, meaning they want to play or meaning they want to go to the park, and the parent or teacher builds off of that word to model to the kid how to build a sentence, the adult would reply “you ‘want to play?’” or “you ‘want to go to the park’”? Trying to teach the kid the terms “want to” and “go to” to build onto the main word the kid has grasped.

However, a Gestalt Language Processor learns chunks of information as one whole. This kid may hear or read a whole phrase and learn that phrase to have a singular meaning as if the sentence was one block instead of made up of multiple blocks of words.

A young Gestalt Language Processor may say “I want to play a game!” because they heard the phrase “want to play a game”, and they associate that with play in general even if it’s not specifically a game they wish to play.

This kid may seem more verbally advanced, as they can repeat long utterances and phrases and seem to understand these concepts in context, however they are not learning more information than an Analytic processor as they view the whole sentence as one chunk of information. They may be able to understand and repeat long complex sentences, but unable to actually break down and explain what each word means by itself or be able to use those words in other sentences.

While you may not remember this, try to think back to a time you were taking a foreign language class or if you have ever done Duolingo. They will give you building blocks to drag each word into a sentence together, teaching you the vocab terms individually and showing you different ways to combine the word to make different phrases.

For example, in a Spanish class, you may have been taught many activity terms such as “bailar” (to dance) “correr” (to run) “cocinar” (to cook) “escribir”(to write) and then also were given terms you could use to describe when and where these activities would take place, such as “fin de la semana”(the weekend) “en la mañana”(in the morning) “por la tarde”(in the afternoon) “mi casa” (my house) “en el parque”(in the park) “mi escuela”(my school) etc and were supposed to combine these terms into sentences to write an essay or answer the questions on the tests.

In those moments, did you find it easier to learn the whole sentence or to build a sentence? For example, did you recall “Donde esta el bano?” as a whole phrase or as “donde” “esta” “el bano” as the separate components put together?

Often confused with depression, Autistic Burnout causes Intense physical, mental, and emotional exhaustion resulting from chronic stress and the continuous effort to cope with a world that may not accommodate autistic needs. This includes a loss of interest in things you used to enjoy, even your special interests that you could hone in on for hours - for example, even if you’re hyperlexic you could find yourself unable to read. Feeling constantly fatigued, often from repressing your natural processing mechanisms and ignoring your needs. It can take months to years to heal from autistic burnout. This requires allowing yourself to acknowledge where you may be pushing yourself too far in life, and how to reconnect with your body to learn how to process and release trapped energy.