Sensory & perceptual disorders in the context of
Donna Williams ‘Fruit Salad’ model of ‘Autism’
Psychiatric Info Processing:
Co Morbids Health Issues
Dyspraxias Personality traits
Agnosias and their associated
Emotional dysregulation disorder extremes
Control Deficits Learned Helplessness
Cat vs Dog
Sensory versus Sensory Perceptual
(not always even related)
(incl Dyspraxia) Agnosias (meaning
Hypersensitivities deafness, meaning
Nutrition & sensitivity disconnectedness
Personality &traits Gut/immune/metabolic
• People are
• People known by
• People known by
hair, clothes or objects
• People known by smell
• Difficulty in the
• Lost in groups
• Bonds with
wallpaper, objects, textur
• Happier with
• May avoid faces or
deeply study own face
• Mirror may be best friend
• Get yourself a 'signature' – a hat, jacket, song, name
• Name yourself upon arrival and when you might be
out of your usual place.
• Show your 'signature' object (ie keyring, watch).
• Offer to be smelled
• Find ways of bonding unrelated to facial recogniation
• Don't take lack of recognition personally.
• Don't take face recognition as a reflection of
inteligence or empathy.
• Teach self advocacy re faceblindness instructions
(even if on a card).
• Find the person a playground buddy who'll find them.
• Create activities where friends are easier to visually
• Be aware people may become strangers when in
bathing costumes, when wet etc.
• Language sounds like blah Meaning
(people sharing sound
• Often worse with other
external sounds (ie fans).
• Common in those with
• Echolalia is common
• Tendency to play with
avoidance of verbal
• Make cover
ears/hum/run/spin to tune
• Preferance for
objects, nature, animals, mir
ror (non-verbal things)
• Use slowed, bullet point, telegraphic speech with
• Gestural signing (showing the use/movements/3D
form associated with words).
• Use representational objects to track speech and
• Provide social opportunities which don't rely on
• Provide means of self advocacy about percentages
and fluctuations in meaning deafness.
• Provide learning opportunities through:
s, movement/hands on learning.
• Many with meaning deafness are also meaning blind
so DO NOT assume picture thinking or learning by
• Ensure visuals involve observable movement/action.
• Use means other than speech to bond.
Meaning • Sees the part, loses the whole.
• Plays with parts of things.
Blindness • Struggles to learn board, group or
• Appears to only recognise specific
• Smells, rubs, taps, flicks, mouths
• Will go without until seeing
someone else use an item.
• Can't imagine others recognise
things/may not seek help.
• Can't process visual context.
• May fear being taught visually or
• Hands on learner. Must DO in
order to learn.
• May have serial memory but can't
visualise something novel.
• Struggles to learn flexible word-
meaning through looking.
• Hands on, discovery learning
• Hand over hand learning ideas
• Rote learning still intact
• Recognition through tapping/smelling/handling.
• Categorise parts
• Choose games/activities which don't rest on visual
• Provide means of self advocacy about meaning blindness.
• Use physical tracing to link visual parts to a 'whole'.
• Tinted lenses or peripheral vision may be employed to filter
incoming information leaving more time to process what's
• Flitting glances and finger movement at the side of the
eyes may each be used to re-set visual processing.
• Ensure inteligence/empathy is not judged by meaning
• Use music, systems, movement for bonding
• May have little use of Agnosia
language or as
• May not respond to
• May stick to non-
• May be more likely to
be bullied/left out.
• May not know how to
initiate or continue
• You Tube, DVD clips, drama classes to formally
teach facial expression/body
• Provide social and employment opportunities not
dependant on reading facial expression/body
• Provide means of self advocating about Social
• Don't take Social Emotional Agnosia as
representative of disinterest or lack of empathy.
• Work with social anxiety associated with
isolation/fear in not being able to process non-
Visual Verbal Agnosia
• May chew, flick, rip
• May read fluently
without intonation or
use it randomly.
• Learns from doing, not
• Prefers letters, lists or
words (when read).
• Loses interest when
pictures are absent.
• Gestural signing, representational objects and
characterisations to bring written words to life
• Lists rather than long strings of 'embedded text'.
• Tinted lenses or muted colored background
may improve processing time.
• Small encyclopedic entries.
• One idea per sentence and one sentence per
• Consider activities/jobs requiring limited ability
to understand contracts, forms or written
• Hands on experience or films rather than books.
• May appear to ignore
that others are and self-other
• Appears to have little
• Appears to go blank
when others are
• Difficulty learning from
• Feels ignored (actually
• Representational objects to track self/other and
topic without losing any of these three.
• Parallel interactions for social success.
• Sit alongside or to the side, not opposite.
• Focus on the object/issue, not the person.
• Advocacy skills re issue.
• Hand over hand teaching and rote physical
• Teaching may have to be sink or swim as may
otherwise not learn actions through modelling.
• Singing, dance, music, arts, sharing nature, to
improve sense of being in company.
Disconnected from Body (body agnosias)
• Late with
toiletting, washing, groomi
• More likely to self injure
• May appear indifferent to
• May have poor sense of
tiredness, need for the
toilet, clothing, hunger, thir
st or comfort from others.
• May behave puppet like or
distressed at being
• Exposure Anxiety may be
• Brain Gym.
• Body brushing, spinning, rolling, massage, tickling.
• Hand over hand rote learning for self
help, toiletting, feeding etc.
• Visible times/lists of routines to replace dysfunctional body
• Rote hand over hand learning for sequencing actions.
• Don't expect self to be identified with/through the body.
• Physical patterning for skills and in following directions.
• An Indirectly Confrontational approach (for Exposure
Anxiety) may be essential.
• Use hand over hand physical tracing and reflection to
experience body as a whole.
• Tapping, rocking and vibration to re-ground in the body.
• Teach rote caretaking of plants/animals and transfer this
to own body.
• O.T exercises for finding toiletting related pushing and
• Difficulty telling body Alexithymia
messages from emotions.
• Difficulty telling one body
message or emotion from
• Difficulty guaging the
degree/volume of a
sensation or feeling and
how to react to it.
• A detached relationship
to body and emotions.
• Poor ability to respond to
the emotional needs of
others in spite of
• Alienation from the
social-emotional world of
• Preference for non-
• Emotional dysregulation
• Modulation games – strong, gentle, scratchy, smooth etc
• A visible scale to assess the 'volume levels' of a feeling.
• Use of representational objects to track competing/contrasting
sensations/feelings and their contributing causes.
• Statements to trigger give away reactions instead of
questions which draw a blank.
• Don't confuse Alexithymia for inability to love or empathise.
• Use real objects to assist in making felt (not rote learned)
• Define differences of fear vs excitement, tiredness vs
anger, happy vs scared, need for the toilet vs feeling cold etc.
• Advocate for the bluntness of those with Alexithymia
particularly re their own feelings (these will commonly be
dismissed if the person appears unemotional in expressing
• Create opportunities which play to the person's strengths.
• Visual thinkers will not have Learning Styles
significant visual perceptual
• Those who can fluently
visualise speech will not have
significant visual and verbal
• Those with visual or verbal
processing disorders may be
unable to internally mentalise
so this will need to be done
externally – hands
objects, gestures, characteris
maps, lists, rote, hand over
hand patterning etc.
• Those with body agnosias
may be unable to transfer the
visual to the physical and
need to physically pattern
gut, immune, metabolic Environmental
disorders, poor nutrition, toxicity
(ie eating fluoride toothpaste) strategies
may improve processing.
• Reduce unnecessary sensory
bombardment but don't pander.
• Work to the person's strengths.
• Don't take their perceptual
• Use respectful strategies aimed
specifically at each issue not
one-size-fits all approaches
thrown at 'the autism'.
• Respectfully help them with self
advocacy and build their sense
• No matter how disabling the
challenges appear, always see
the person, not just the
disability. Then they might too.
For more information
see the books
Autism; An Inside Out Approach
The Jumbled Jigsaw
also more info at