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Transcript
Sensory Differences
Research Digest
Do we have sensory profiles of all students?
Apupil’ssensoryprofilewouldbeputtogetherbyamemberoftheOccupationalTherapyteam
alongsidestaffwhoworkwiththatpupil.Inputfromparentswillalsobesought.Notallpupilswill
haveasensoryprofile,onlythosewho,basedontheprofessionaljudgementofthestaffand
therapyteam,mightrequiresupportoverandabovethatwhichisprovidedtosupportthesensory
needsofallourpupils.Thisbaselinelevelofsensorysupportisinplaceasweknowthatallofour
pupils,tovaryingdegrees,experiencedifferencesinthewaytheyreceiveandmanagesensoryinput.
Thisweekwewilllookatsensorydifferencesandtheirimpact(thiswillbeatwoparter!).
Sensorydifferences
Therelationshipbetweendifferencesanddifficultiesinprocessingandintegratingsensory
informationandautismiswellestablishedinboththeresearchliterature(Ben-Sassonetal.2008;
Minshew,Sweeney,&Luna2002;Rogers,Hepburn,&Wehner,2003;Rogers&Ozonoff2005)and
first-handaccounts(e.g.Grandin,2006;Higashida,2013;Kirby,Dickie&Baranek,2015;Williams,
1992;1994).Sensoryfeaturesarealsonowincludedinthediagnosticcriteriaforautism(American
PsychiatricAssociation,APA,2013).Specifically,‘‘hyper-orhypo-reactivitytosensoryinputor
unusualinterestinsensoryaspectsoftheenvironment’’qualifiesasoneoffoursub-criteria(two
sub-criteriaarerequired)inthe‘restricted,repetitivepatternsofbehavior,interests,oractivities’
diagnosticdimension(CriteriaB)oftheDSM-5(APA,2013).However,thetypesofsensory
difficultiesexperiencedareoftenhighlyidiosyncratictoeachindividual(Ausderauetal.,2014Lane,
Molloy,&Bishop,2014).
AsinmanyotherareastherehasbeenlessworkonexaminingsensorydifferencesinPMLD,partly
becauseourPMLDstudentsdifferfromeachothertoanevengreaterextentthanourautisticpupils.
Wedoknow,however,thatthesensoryworldexperiencedbyourPMLDpupilscanalsobemoreor
lessintensethanneurotypicalpupilsoftenasaresultofspecificsensoryimpairmentsandthe
resultantdifferenceinperceptioninothersensorysystems(soundforexampleinthosepupilswho
arevisuallyimpaired)(Gougoux,etal.,2005).Multisensoryapproachestocommunicationand
learningarealsowellestablishedmethodsforsupportingpupilswithPMLD(Goldbart,Chadwick&
Buell,2014).
IllustrationfromSmith-Myles,Mahler&Robbins,2014
Typicallythefocus,inautism,hasbeenonlookingat
differences(hyperorhyporesponsiveness)acrosssevensenses–sight,smell,taste,
touch,hearing,vestibular(balance)andproprioception(awarenessofbodyin
space).However,anewareaofresearchhasbeenexaminingtheimpactof
IllustrationfromSmith-Mylesetal.2014
differencesin‘theeighthsense’–interoception.
Heartfelt,gutfeeling
Thebasicprocessofinteroceptionrelatesto
howsensorysignalsrelatingtointernalbody
experiencessuchaspain,temperature,itch,
sensualtouch,muscularandvisceral
sensations,heartrate,hunger,thirst,
fullness,nausea,needforthetoilet,tickle
andemotionalstatessuchasanger,
calmness,distraction,orfearreachour
consciousawareness(Craig,2003;2015).
Interoceptionhelpstoallowustoanswer
thequestion,"HowdoIfeel?".
Whilstthereisagrowingbodyofresearch
lookingathowemotional
Illustration:ElanaRyznar
experienceisgovernedby
interospectiveawareness(Bechara&Naqvi,2004;Seth,2013)andtherelationshipbetween
interoceptionandstress(Garfinkel&Critchley,2016a;Schulz&Vögele,2015)ithasonlyrecently
beguntobeexaminedinchildrenandyoungpeople.Forexample,arecentreviewintosensory
factorsandtheirimpactondailylifeforchildrenbyDunnandcolleagues(Dunn,Little,Dean,
Robertson&Evans,2016)didnotincludeanyexaminationofinteroception,despitethegrowing
evidencetosupportthevitalroleitplaysinourunderstandingofourselves,ouremotions,other
peopleandthewiderworld(Murphy,Brewer,Catmur&Bird,2016).Inlightofthisunderstanding
andsensorydifferencesexperiencedbyautisticindividualstherehasbeenanewfocusonlookingat
therelationshipbetweeninteroceptiveawarenessandautism.
Theimportantroleinteroceptionplaysintermsofoursocio-cognitiveability,andourabilityto
distinguishselffromother(Quattrocki&Friston,2014;Sowden,Brewer,Catmur&Bird,2016)
suggeststhissensemaybeexperiencedsignificantlydifferentlyinautisticindividuals.Therefore,
despitethehugevarietyinwhichitisexpressed,theremaybeacommoninteroceptivefoundation
toautism(Seth&Friston,2016).Arecentreviewofresearchoninteroceptionandautismwhilst
limitedtojustfivestudies,doessuggestthatdifferencesininteroceptiveawarenessmayunderpin
manyofthedifficultiesourautisticpupilsexperience(DuBois,Ameis,Lai,Casanova&Desarkar,
2016).However,theresearchtodateislimitedtolowerneedindividuals,partlyduetothefactone
ofthemainmeasuresofinteroceptiveawarenesscomesthroughself-reportquestionnairesortasks
suchasanindividualhavingtorateifamusicalbeatortonematchestheirheartbeat(Garfinkelet
al.,2016b).Alotmoreresearch
isneeded,particularlywith
higherneedindividuals,tolook
attheextenttowhichthere
maybeatendencytowards
hyperorhyporesponsivityto
interoceptivesensationsbut
also,moreimportantly,howto
supportindividualstomanage
andunderstandthishighly
Image:IanKelckneradaptedbyGraceBullock
influentialsensoryinformation-toknow‘howdoIfeel?’
Sensorysubtypesinautism?
Sensorybehaviourshave
historicallybeendividedinto
fourpatterns,includingsensory
hypo-reactivity,hyper-reactivity,
sensoryseeking,andsensory
avoidance(Dunn,2001;BenSassonetal.,2009).However,
manyautisticindividualswill
experienceseveralofthese
patternsatonetime,withmixedpatternsbeingdisplayedacrosssensorydomains(taste,touchetc.)
(Baraneketal.,2006;TomchekandDunn,2007;Lidstoneetal.,2014).Recentresearch,therefore,
hastriedtoclassifysensoryprocessingdifferencesintospecificsubtypes(Laneetal.,2011,2014;
Uljarevićetal.,2016),suchassensoryadaptive,sensorymoderate,andsensorysevere(Uljarevićet
al.,2016),withaviewtoensuringsupportcanbeindividualisedfurther.
Whilstresearchershavecautionedagainstover-generalising,areviewpublishedthisyearsuggested
thatbetweenthreetofivesensorysubtypeswasanappropriate‘fit’toencompassthedifferent
patternsofsensoryresponsivityseeninchildrenwithautism:asubgroupmayhavetypicalsensory
functioning,whilstanothersuggestedsubgroupincludedchildrenwithsignificant,globalsensory
differences(DeBoth&Reynolds,2017).Thereweremixed,lessconclusiveresultsforthosechildren
whomayfallinbetweenthesetwo‘end-points’–thosewhohavespecificversusglobaldifferences
inresponsivity(i.e.,hyper-orhypo-responsivityorsensoryseeking),orwithinspecificsensory
domains(vestibular,tasteetc.)(DeBoth&Reynolds,2017).
Withregardstoautisticindividualswithhigherneeds,includingthosewithadditionalintellectual
difficultiesand/orlimitedverbalcommunication,therehasbeensomeconsensusthattheymay
experiencehypo-responsivityandhigherratesofsensoryseekingbehaviour(Patten,Ausderau,
Watson,&Baranek,2013;Watts,Rodgers&Riby,2016).Hyper-responsivityontheotherhandhas
beenassociatedwithsleepproblems(MazurekandPetroski,2015)andfooddisorders(Cermaket
al.,2010;Nadonetal.,2011),particularlyinveryyoungchildrenandinfants,suggestingearly
sensorybasedsupportsmayhelpaddressthesedifficulties(Taumanetal.,2016).Sensoryhyperresponsivenesshasalsobeenlinkedtogastrointestinal(GI)problems(Mazureketal.,2013)more
externalizingbehaviors,andincreasedparentingstress(Ben-Sassonetal.,2013).Again,the
implication,therefore,isthatabetterunderstandingofdifferentsensoryprofilesandtherefore
moreindividualisedsensoryinterventions
andsupportmayhelptoaddressthese
difficulties.Thereisalsoawidercallfor
futureresearchtolookatsensorysubtypes
ineverybodytohelpunderstandifsensory
subtypesinautisticindividualsare
representativeofgeneraldifferencesin
sensoryprocessing(DeBoth&Reynolds,
2017).
Illustration:BenConnors,retrievedfromhttp://crae.ioe.ac.uk/post/145502740383/making-sense-of-sensory-differences Impactofsensorydifferences
Overtwentyyearsagointheirbookontheimportanceofsensoryintegration,Williamsand
Shellenbergerputforwardadevelopmentalmodeloflearning,thefoundationsofwhicharesensory
(althoughtheydidnotincludeinteroception)(Williams&Shellenberger,1996).
PyramidofLearning(Williams&Shellenberger,1996)
Whilstthismodelprovidesagreatvisualreminderoftheroleofphysiologicalprocessesincognition
ingeneral,theimpactofsensorydifferencesforautisticindividualsisfarmorepervasiveand
understandingthesedifferencesineachindividualisevenmorecrucialtounderstandingtheir
specificneedsandbehaviour(Schaaf&Lane,2105)
Managingsensorydifferencesprovidesoneofthemostchallenging
obstaclesforchildrenandyoungpeoplewithautism,impactingupon
adaptivebehaviour,participationinactivitiesinthecommunity,and
reducingqualityoflife(Baraneketal.2006;Bakeretal.2008;BenSassonetal.2013;O’NeillandJones1997;O’RiordanandPassetti2006;
Schaafetal.2011).
Difficultywithsensoryregulationhasalso
beenconsideredtobemotivatingstereotypic
behaviour.Indeed,repetitivebehavioursinautism,havelongbeenassociatedwithfluctuatingstates
ofunder(hypo)andover(hyper)sensoryarousal,andstereotypicorrepetitivebehavioursarea
meansoftryingtofiximbalances(self-regulate)inarousalinthefaceorunpredictable,potentially
overwhelmingsensoryinputtoachieveoptimalstimulation‘calmalert’(Lidstoneetal.,2014;
Matsushimaetal.,2016;Zentall&Zentall,1983).
Illustration:KellyDillon
However,differenttypesofrepetitivebehavioursmayservedifferentfunctionsforregulating
sensoryarousalwithvaryinglevelsofsuccesstheseare:InsistenceonSameness(IS)andRepetitive
SensoryandMotorBehavioursRSMB).
InsistenceonSameness(IS)
ISbehavioursinclude:collectingorhoardingitemsofanysort,insistingonthingsremainingthe
same,gettingupsetaboutminorchangestoobjects,insistingonaspectsofroutineremainingthe
same,insistingondoingorre-doingthingsinacertainway,playingthesamemusic,game,video,
bookrepeatedly.Thesetypesofbehavioursarelinkedtoover-arousalasaresultofsensory
sensitivity(hyper-sensitivity).Therefore,thesebehavioursmayfunctionbybeingsensationavoiding
andallowtheindividualtonarrowsensoryinput–theyprovideafocustohelpblockoutother
sensoryinput.However,thelinkbetweentheseISbehavioursandanxietyindicatesthatthese
behavioursmaynotbethebestwayofregulatingarousalandtheymayevenservetocreateand
maintainanxiety.
RepetitiveSensoryandMotorBehaviours(RSMB)
RSMBsinclude:repetitivelyfiddlingwithtoysetc.,spinningselfaroundandaround,rocking
backwardsandforwards,pacing/movingaroundrepetitivelyandrepetitivehand/fingermovements.
Thesetypesofbehavioursmaybemuchbetterathelpingtoregulatearousalwithoutcreatingor
maintaininganxiety,byprovidingstimulationthroughsensationseekinginthecaseofunder-arousal
(hypo-sensitivity)andthroughsoothingandavoidanceoutcomesinthecaseofover-arousal(hypersensitivity).Howeverthesebehaviourshavealsobeenpositivelyassociatedwithparent-reported
sleepproblems(Hundley,Shui&Malow,2016).
Overall,whenlookingatritualisticbehaviourssuchasthosedescribedabove,currentopinionisthat
theydevelopasacopingmechanisminresponsetoanxiety.Thisinturncomesfromprimary
difficultiesinmodulatingsensoryinput(Bart,Bar-Shalita,Mansour&Dar,2016).Thisrelationship
betweenanxietyandsensorydifferenceswillbethemainfocusofPart2ofthisdigestwhich
exploresthecloserelationshipbetweensensoryregulationandanxietyfurther(Magiatietal.,2015;
Samsonetal.,2014).
Seephysicalthinksensory
Onefinalthingtokeepinmindisthatwemustconsiderthatmuchphysical
behaviourismotivatedbysensoryneedsand,asmentionedabove,maybea
childoryoungpersonmaybetryingtoregulatetheiranxietyorsensory
needs.Thismayincludeself-injuriousbehaviourswhichmaybeconsidered
moreintensestereotypic/repetitivebehaviours(Gal,Dyck&Passmore,
2009).
Foralongtimephysicalbehaviourinautismwasmisunderstood.Unlike
otherareasofdifferencesuchasTourette’s,asocialratherthananeurologicalinterpretationof
behaviourwasappliedsothat“whichiscalleda“tic”inapersonwithTourettesyndromeismost
oftenassumedtobea“behaviour”(andoftenaconsciouschoice)inapersonwithautism.For
symptomsinterpretedthroughaneurologicallens,individualstendtobeappropriatelysupported.In
autism,symptomsareviewedfrequentlyasbehaviourstobereducedoreliminatedoftenwitha
negativeinterventionandresults”(Donnellan,Hill&Leary,2013).Donnellanandcolleaguesfurther
pointoutthatasocialinterpretationofthesesensorymotivatedbehavioursoftenleavespeople
withtheassumptionthattheyoccurasamatterofchoiceorapathy,whereaspredominantlythe
behaviourisrelatedtostress,includingthestressofexcitement(Donnellan,Hill&Leary,2013).
Whilstunderstandingthattheremaybephysiologicaldifferencethatcouldbemotivatingsensory
behavioursitisalsoimportantthatwerememberthatwecanstillsupportourpupilstolearnother
waysofregulatingthemselves,andindeedtobecomemoreabletocopewithsensoryinputthat
maybeprovokinganxiety.Simplistic,neuroessentialist(biologicallybased)explanationsof
differencescanoftenleadtowardsanincreaseinstigma,lessempathyandaclosedmindset
towardsassumingthatdifficultiesindividualsmayfacearefixed(Lebowitz&Ahn,2014;Schultz,
2015).
References
AmericanPsychiatricAssociation.(2013).Diagnosticandstatisticalmanualofmental
disorders:DSM-5.Washington,D.C:AmericanPsychiatricAssociation.
Ausderau,K.K.,Furlong,M.,Sideris,J.,Bulluck,J.,Little,L.M.,Watson,L.R.,Boyd,B.A.,Belger,A.,
Dickie,V.A.,&Baranek,G.T.(2014).Sensorysubtypesinchildrenwithautismspectrumdisorder:
latentprofiletransitionanalysisusinganationalsurveyofsensoryfeatures.JournalofChild
PsychologyandPsychiatry.55(8),935-944
Bart,O.,Bar-Shalita,T.,Mansour,H.,&Dar,R.(2016).RelationshipsamongSensoryResponsiveness,
Anxiety,andRitualBehaviorsinChildrenwithandwithoutAtypicalSensoryResponsiveness.Physical
&OccupationalTherapyInPediatrics,1-10.
Bechara,A.,&Naqvi,N.(2004).Listeningtoyourheart:interoceptiveawarenessasagatewayto
feeling.Natureneuroscience,7(2),102-103.
Ben-Sasson,A.,Cermak,S.,Orsmond,G.,Tager-Flusberg,H.,Kadlec,M.,&Carter,A.(2008).Sensory
clustersoftoddlerswithautismspectrumdisorders:Differencesinaffectivesymptoms.Journalof
ChildPsychologyandPsychiatry,49(8),817-825.
Ben-Sasson,A.,Hen,L.,Fluss,R.,Cermak,S.A.,Engel-Yeger,B.,&Gal,E.(2009).Ameta-analysisof
sensorymodulationsymptomsinindividualswithautismspectrumdisorders.JournalofAutismand
DevelopmentalDisorders,39,1–11.
Boyd,B.A.,Baranek,G.T.,Sideris,J.,Poe,M.D.,Watson,L.R.,Patten,E.,&Miller,H.(2010).
Sensoryfeaturesandrepetitivebehaviorsinchildrenwithautismanddevelopmentaldelays.Autism
Research,3(2),78–87.
Craig,A.,D.,(2003).Interoception:thesenseofthephysiologicalconditionofthebody.Current
OpinionsinNeurobiology,13,500–505.
Craig,A.,D.,(2015).HowDoYouFeel?:AnInteroceptiveMomentwithYourNeurobiologicalSelf.
PrincetonUniversityPress,NewYork.
DeBoth,K.K.,&Reynolds,S.(2017).Asystematicreviewofsensory-basedautism
subtypes.ResearchinAutismSpectrumDisorders,36,44-56.
Donnellan,A.M.,Hill,D.A.,&Leary,M.R.(2013).Rethinkingautism:implicationsofsensoryand
movementdifferencesforunderstandingandsupport.Front.Integr.Neurosci,6.
DuBois,D.,Ameis,S.H.,Lai,M.C.,Casanova,M.F.,&Desarkar,P.(2016).InteroceptioninAutism
SpectrumDisorder:Areview.InternationalJournalofDevelopmentalNeuroscience,52,104-111.
Gal,E.,Dyck,M.J.,&Passmore,A.(2009).Therelationshipbetweenstereotypedmovementsand
self-injuriousbehaviorinchildrenwithdevelopmentalorsensorydisabilities.Researchin
DevelopmentalDisabilities,30(2),342-352.
Garfinkel,S.N.,&Critchley,H.D.(2016a).Threatandthebody:howtheheartsupportsfear
processing.Trendsincognitivesciences,20(1),34-46.
Garfinkel,S.N.,Tiley,C.,O'Keeffe,S.,Harrison,N.A.,Seth,A.K.,&Critchley,H.D.(2016b).
Discrepanciesbetweendimensionsofinteroceptioninautism:implicationsforemotionand
anxiety.Biologicalpsychology,114,117-126.
Goldbart,J.,Chadwick,D.,&Buell,S.(2014).Speechandlanguagetherapists’approachesto
communicationinterventionwithchildrenandadultswithprofoundandmultiplelearning
disability.Internationaljournaloflanguage&communicationdisorders,49(6),687-701
Gougoux,F.,Zatorre,R.J.,Lassonde,M.,Voss,P.,&Lepore,F.(2005).Afunctionalneuroimaging
studyofsoundlocalization:visualcortexactivitypredictsperformanceinearly-blind
individuals.PLoSBiol,3(2),e27.
Grandin,T.(2006).Thinkinginpictures.London:Bloomsbury
Green,S.A.,&Ben-Sasson,A.(2010).Anxietydisordersandsensoryover-responsivityinchildren
withautismspectrumdisorders:isthereacausalrelationship?.Journalofautismanddevelopmental
disorders,40(12),1495-1504.
Green,S.A.,&Ben-Sasson,A.(2010).Anxietydisordersandsensoryover-responsivityinchildren
withautismspectrumdisorders:Isthereacausalrelationship?JournalofAutismandDevelopmental
Disorders,40,1495–1504
Green,S.A.,Ben-Sasson,A.,Soto,T.W.,&Carter,A.S.(2012).Anxietyandsensoryover-responsivity
intoddlerswithautismspectrumdisorders:Bidirectionaleffectsacrosstime.JournalofAutismand
DevelopmentalDisorders,42,1112–1119.
Hundley,R.J.,Shui,A.,&Malow,B.A.(2016).RelationshipBetweenSubtypesofRestrictedand
RepetitiveBehaviorsandSleepDisturbanceinAutismSpectrumDisorder.Journalofautismand
developmentaldisorders,46(11),3448-3457.
Higashida,N.(2013).TheReasonIJump.(D.Mitchelltrans.)London:Hodder&Stoughton
Joosten,A.,&Bundy,A.C.(2010).Sensoryprocessingandstereotypicalandrepetitivebehaviorin
childrenwithautismandintellectualdisability.AustralianOccupationalTherapyJournal,57,366–
372.
Kirby,A.V.,Dickie,V.A.,&Baranek,G.T.(2015).Sensoryexperiencesofchildrenwithautism
spectrumdisorder:Intheirownwords.Autism,19(3),316-326.
Lane,A.E.,Molloy,C.A.,&Bishop,S.L.(2014).Classificationofchildrenwithautismspectrum
disorderbysensorysubtype:Acaseforsensory-basedphenotypes.AutismResearch,7(3),322-333.
Lebowitz,M.S.,&Ahn,W.K.(2014).Effectsofbiologicalexplanationsformentaldisorderson
clinicians’empathy.ProceedingsoftheNationalAcademyofSciences,111(50),17786-17790.
Lidstone,Jane,Uljarevic,Mirko,Sullivan,J.,Rodgers,J.,McConachie,H.,Freeston,M.,LeCouteur,
A.,Prior,M.andLeekam,SusanR.(2014).Relationsamongrestrictedandrepetitivebehaviors,
anxietyandsensoryfeaturesinchildrenwithautismspectrumdisorders.ResearchinAutism
SpectrumDisorders8(2),pp.82-92.
Magiati,I.,Ong,C.,Lim,X.Y.,Tan,J.W.L.,Ong,A.Y.L.,Patrycia,F.,...&Howlin,P.(2015).Anxiety
symptomsinyoungpeoplewithautismspectrumdisorderattendingspecialschools:Associations
withgender,adaptivefunctioningandautismsymptomatology.Autism,1362361315577519.
Matsushima,K.,Matsubayashi,J.,Toichi,M.,Funabiki,Y.,Kato,T.,Awaya,T.,&Kato,T.(2016).
Unusualsensoryfeaturesarerelatedtoresting-statecardiacvagusnerveactivityinautismspectrum
disorders.ResearchinAutismSpectrumDisorders,25,37-46.
Minshew,N.,Sweeney,J.,&Luna,B.(2002).Autismasaselectivedisorderofcomplexinformation
processingandunderdevelopmentofneocorticalsystems.MolecularPsychiatry,7,S14.
Murphy,J.,Brewer,R.,Catmur,C.,&Bird,G.(2016).Interoceptionandpsychopathology:A
developmentalneuroscienceperspective.DevelopmentalCognitiveNeuroscience.
Pellicano,E.,&Burr,D.(2012).Whentheworldbecomes‘tooreal’:aBayesianexplanationof
autisticperception.Trendsincognitivesciences,16(10),504-510.
Quattrocki,E.,&Friston,K.(2014).Autism,oxytocinandinteroception.Neuroscience&
BiobehavioralReviews,47,410-430.
Rogers,S.J.,&Ozonoff,S.(2005).Annotation:Whatdoweknowaboutsensorydysfunctionin
autism?Acriticalreviewoftheempiricalevidence.JournalofChildPsychologyandPsychiatry,
46(12),1255-1268.
Rogers,S.J.,Hepburn,S.,&Wehner,E.(2003).Parentreportsofsensorysymptomsintoddlerswith
autismandthosewithotherdevelopmentaldisorders.JournalofAutismandDevelopmental
Disorders,33(6),631-642.
SamsonAC,PhillipsJM,ParkerKJ,etal.(2014)Emotiondysregulationandthecorefeaturesof
autismspectrumdisorder.JournalofAutismandDevelopmentalDisorders44(7):1766–1772.
Schaaf,R.C.,&Lane,A.E.(2015).Towardabest-practiceprotocolforassessmentofsensory
featuresinASD.Journalofautismanddevelopmentaldisorders,45(5),1380-1395.
Schultz,W.(2015).NeuroessentialismTheoreticalandClinicalConsiderations.JournalofHumanistic
Psychology,0022167815617296.
Schulz,A.,&Vögele,C.(2015).Interoceptionandstress.Frontiersinpsychology,6,993.
Seth,A.K.(2013).Interoceptiveinference,emotion,andtheembodiedself.Trendsincognitive
sciences,17(11),565-573.
Seth,A.K.,&Friston,K.J.(2016).Activeinteroceptiveinferenceandtheemotional
brain.PhilosophicalTransactionsoftheRoyalSocietyB:BiologicalSciences,371(1708),20160007.
Sowden,S.,Brewer,R.,Catmur,C.,&Bird,G.(2016).Thespecificityofthelinkbetweenalexithymia,
interoception,andimitation.JournalofExperimentalPsychology:HumanPerceptionand
Performance,42(11),1687.
Tauman,R.,Avni,H.,Drori-Asayag,A.,Nehama,H.,Greenfeld,M.,&Leitner,Y.(2016).Sensory
profileininfantsandtoddlerswithbehavioralinsomniaand/orfeedingdisorders.SleepMedicine.
Watts,S.J.,Rodgers,J.,&Riby,D.(2016).ASystematicReviewoftheEvidenceforHyporesponsivity
inASD.ReviewJournalofAutismandDevelopmentalDisorders,3(4),286-301.
Williams,D.(1992).NobodyNowhere:Theextraordinaryautobiographyofanautistic.London:
Doubleday.
Williams,D.(1994).SomebodySomewhere:Breakingfreefromtheworldofautism.NewYork:Times
Book
Williams,M.S.,&Shellenberger,S.(1996).Howdoesyourenginerun?:Aleader'sguidetothealert
programforself-regulation.TherapyWorks,Inc..
Woo,C.C.,Donnelly,J.H.,Steinberg-Epstein,R.,&Leon,M.(2015).Environmentalenrichmentasa
therapyforautism:Aclinicaltrialreplicationandextension.Behavioralneuroscience,129(4),412.
Zentall,S.S.,&Zentall,T.R.(1983).Optimalstimulation:Amodelofdisorderedactivityand
performanceinnormalanddeviantchildren.PsychologicalBulletin,94,446-471.