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Autism: Sensing the World in Different Ways


April is Autism Awareness Month, a time to focus attention on this condition that affects one in 68 children in the U.S., according to the Centers for Disease Control and Prevention (CDC). Autism Spectrum Disorder (ASD) is a complex developmental disorder that can cause problems with thinking, feeling, language and the ability to relate to others.

Sensory differences, such as being overly sensitive to sound, are often associated with autism. Some 70 percent or more of people with autism have differences in sensory perception and processing.1 People with autism spectrum disorder often sense the world in different ways—they may be over-sensitive to things in the environment or they may be under-sensitive. They may also have difficulties combining and integrating information from multiple senses, which is necessary for perceiving and understanding.


While sensory differences have long been associated with autism, it wasn’t until 2013 with the publication of DSM-5, that sensory issues were added to the diagnostic criteria for autism.2

Sensory differences can affect a person’s behavior and if they are more severe, can significantly affect a person’s life. Sensory integration difficulties can cause distress and confusion and can relate to behaviors commonly associated with autism, such as avoiding eye contact or repetitive behaviors. If a person has difficulty processing sensory information, he/she can more easily experience sensory overload which can contribute to stress and anxiety and a person withdrawing, having a ‘meltdown,’ or other reactions. New research continues to document and clarify sensory differences.


Some people with autism are overly sensitive to sound and may have difficulties handling any loud noise or may find it difficult to ‘tune-out’ some sounds to focus on specific sounds (e.g., to focus on a person talking to you if there are several conversations going on around you) Some people with autism are under-sensitive to sound and may appear to not hear or not pay attention to certain sounds and some particularly seek out loud noises.


Much research has focused on difficulties of people with autism relating to face recognition and with understanding facial expressions. On the other hand, many people with autism have an increased ability to see visual differences—they are more likely to notice changes or differences in what they see than their peers.


Compared to people without autism, people with autism often perceive surfaces as rougher. Some are only comfortable in certain loose-fitting clothing and for some just being touched can be uncomfortable or painful.


Some people with autism report a heightened sense of smell. One study found that people with autism were able to detect the odor at significantly greater distance than people without autism. The sensitivity was higher in those with more severe autism traits.


Some people with autism spectrum disorder are overly sensitive and find some flavors or foods to strong so they seek out bland foods. Others, however, crave very strong-tasting or spicy foods.

Sense of movement (vestibular system) and awareness of body position (proprioception) can also be affected in people with autism.

The authors of a recent study on sensory function in people with autism argue that “sensory processing is not only an additional piece of the puzzle, but rather a critical cornerstone for characterizing and understanding ASD.”1 Help is available for people with sensory issues. Occupational and physical therapists work with people with sensory processing difficulties in a variety of ways to help them address or cope with their sensory issues.


Autism Awareness Month

Learn more about autism spectrum disorder, including symptoms, risk factors, treatment options and answers to your questions written by leading psychiatrists.

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If you are interacting with a person with autism, try to learn what sensitivities the person has, be aware of the environment. Part of increasing our awareness and understanding of people with autism is to keep in mind that that the way they perceive things in their environment and their ability to process that information may be very different from most people.



  1. Yasuda U, et al. 2016. Sensory cognitive abnormalities of pain in autism spectrum disorder: a case-control study. Annals of General Psychiatry, 15:8.
  2. DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Association. (2013). The diagnostic criteria in DSM-5 for autism spectrum disorder includes: “Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).”
  3. Baum SH, Stevenson RA, Wallace MT. 2015. Behavioral, perceptual, and neural alterations in sensory and multisensory function in autism spectrum disorder. Prog Neurobiol, 134:140-60


AutismPatients and Families


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