Sensory and Motor Challenges in Autism, ADHD, and AuDHD

 Sensory and Motor Challenges in Autism, ADHD, and AuDHD

Autism and ADHD each bring unique sensory and motor challenges, but when they co-occur in the form of the combined diagnosis of AuDHD (Autism and ADHD), these difficulties become more complex and intertwined. Sensory processing and motor coordination are integral to navigating daily life, and disruptions in these areas can affect everything from focus and comfort to physical activity and social interactions. Understanding the nuances of sensory and motor challenges in autism, ADHD, and AuDHD offers valuable insights into how individuals with this combined diagnosis (AutDers)experience the world.

Sensory Processing in Autism and ADHD

Both autism and ADHD present distinct sensory processing challenges, but they manifest in different ways.

Autism: Sensory Sensitivities and Overload

Autistic individuals frequently experience heightened sensitivity to sensory stimuli. This can make ordinary environments, like busy streets or noisy classrooms, overwhelming.

  • Hypersensitivity: Autistics may find certain stimuli, such as bright lights, loud noises, or specific textures, overwhelming or even painful. Sensory overload is a common occurrence, leading to meltdowns, anxiety, or the need to withdraw from overstimulating environments.

  • Difficulty with Sensory Modulation: Autistics often struggle with modulating their responses to sensory input. Even minor changes in their sensory environment can provoke strong reactions, like a startle response or a need to leave the space immediately to calm down.

ADHD: Sensory Seeking and Distractibility

In ADHD, sensory processing challenges often manifest in the opposite direction, with individuals seeking out sensory input to maintain attention.

  • Sensory Seeking: ADHDers engage in behaviors to increase sensory stimulation. This might involve fidgeting, tapping, doodling, or moving around constantly to help regulate focus and engagement with tasks.

  • Distractibility: ADHD is also associated with difficulty filtering out irrelevant sensory input. In noisy or visually stimulating environments, ADHDers may struggle to focus on tasks as their attention shifts rapidly between multiple sensory inputs.

Sensory Processing in AuDHD: Amplified and Varied

In AuDHD, sensory challenges become even more complex, combining the hypersensitivities of autism with ADHD’s craving for stimulation. This results in a dynamic and sometimes conflicting relationship with sensory input.

  • Sensory Hyper- and Hyposensitivity: Individuals with AuDHD (or AutDers)may fluctuate between being overwhelmed by sensory stimuli (autism) and actively seeking out more intense sensory input to maintain focus (ADHD). This creates a push-pull dynamic, where one day a noisy environment may be unbearable, and the next day, they might seek out a stimulating setting for focus.

  • Sensory Overload vs. Sensory Seeking: An AutDer might be overstimulated in a chaotic, noisy environment but feel distracted or restless in a quiet, low-stimulation setting. This unpredictable relationship with sensory input can make it difficult to regulate responses and maintain comfort throughout the day.

Motor Coordination in Autism and ADHD

Motor coordination issues are common in both autism and ADHD, but the manifestations are distinct for each condition.

Autism: Repetitive Movements and Dyspraxia

In autism, motor challenges often manifest through repetitive behaviors and difficulty with motor planning.

  • Stimming: Autistic individuals frequently engage in repetitive movements like hand-flapping, rocking, or spinning (known as stimming). These behaviors help manage sensory input or emotional regulation and can serve as self-soothing mechanisms.

  • Dyspraxia: Many autistic individuals experience motor planning difficulties, known as dyspraxia. This can affect tasks that require fine motor skills, like handwriting or using utensils, as well as gross motor skills, such as running or jumping. This lack of coordination can lead to frustration or a reluctance to engage in physical activities.

ADHD: Restlessness and Impulsivity

Motor challenges in ADHD are often characterized by a need for constant movement and impulsive actions.

  • Motor Restlessness: ADHDers often feel the need to move constantly, whether it’s tapping their feet, pacing, or fidgeting. This restlessness helps them stay engaged but can become disruptive in environments that require stillness or focus, like classrooms or meetings.

  • Impulsive Movements: ADHD can also lead to impulsive, poorly timed movements, such as acting without thinking through the consequences. This may result in accidents or difficulty executing tasks that require careful motor planning, like playing sports or handling delicate objects.

Motor Challenges in AuDHD: Coordination and Regulation

When autism and ADHD co-occur in AuDHD, motor challenges can be exacerbated, blending the traits of both conditions into a complex pattern of movement and coordination difficulties.

  • Increased Stimming and Restlessness:  AutDers may find that their need for repetitive movements (stimming) increases due to ADHD’s impulsivity and restlessness. While stimming can help regulate sensory input and focus, it can also interfere with tasks that require stillness or sustained concentration, such as schoolwork or meetings.

  • Motor Coordination Issues: Tasks that require both fine and gross motor coordination, like handwriting or playing sports, may be especially difficult for AutDers

  • . Autism’s motor planning challenges combine with ADHD’s impulsive and poorly timed movements, leading to clumsiness, accidents, or difficulty completing activities that require precision.

  • Balance and Spatial Awareness: Vestibular processing issues in AuDHD may also affect balance and spatial awareness. This can make it harder for individuals to maintain steady footing, avoid obstacles, or participate in physical activities that require coordinated movement, such as dancing or playing sports.

Sensory-Motor Synchrony and Feedback Loops

Tasks that require integrating sensory input with motor responses, like playing catch or cooking, can be particularly difficult for those with AuDHD.

Sensory-Motor Coordination

Individuals with AuDHD may struggle with tasks that require them to coordinate sensory input with motor responses. Autism’s delayed sensory processing may make it harder to time movements accurately, while ADHD’s impulsivity can cause poorly timed actions.

  • Timing and Coordination Issues: For instance, catching a ball might be difficult because the individual can’t synchronize their visual and motor systems quickly enough, or they might act impulsively and miss the catch. These difficulties can extend to daily tasks like cooking, where multiple sensory inputs (sight, smell, touch) need to be integrated for successful task completion.

Sensory-Motor Feedback Loops

Sensory-motor feedback—the brain’s ability to judge how the body interacts with its environment—may also be impaired in AuDHD.

  • Misjudging Force and Space: AutDers may misjudge how much force is needed for tasks, like gripping objects too tightly or too loosely, leading to accidents. They may also struggle with spatial awareness, frequently bumping into objects or people. These difficulties can lead to frustration and a sense of clumsiness, especially in social or physical activities.

Additional Sensory and Motor Issues in AuDHD

The combination of autism and ADHD introduces several more nuanced sensory and motor issues that are worth noting.

Difficulty with Sensory Modulation

Individuals with AuDHD may have fluctuating abilities to regulate sensory input. Some days they might be able to tolerate sensory stimuli that overwhelm them on other days. This inconsistency can make sensory regulation unpredictable and lead to confusion about what environments or stimuli will be manageable.

  • Overstimulation Followed by Seeking More Input: After experiencing sensory overload, instead of needing rest or withdrawal (as is common in autism), AutDers might feel compelled to seek more sensory input due to ADHD’s craving for stimulation. This can create a confusing pattern of seeking and avoiding sensory experiences.

Fatigue from Sensory-Motor Efforts

Managing sensory overload, stimming, and motor coordination issues can be physically exhausting for individuals with AuDHD.

  • Sensory Exhaustion Coupled with Restlessness: Sensory overload is tiring for anyone, but in AuDHD, the need to move (due to ADHD) can persist even when the body is exhausted. This can lead to burnout or physical fatigue, as the individual’s body is pushed beyond its limits without sufficient rest.

  • Cognitive Fatigue: The constant effort required to process sensory inputs and manage motor movements can lead to cognitive fatigue. This might manifest as irritability, difficulty concentrating, or emotional dysregulation, especially after extended periods of sensory-motor effort.

Impact on Learning and Daily Activities

Sensory and motor challenges can significantly affect learning, daily tasks, and social interactions for those with AuDHD.

  • Learning Challenges: In academic environments, AutDers may struggle with activities that require fine motor skills (e.g., writing, using school supplies) or tasks that involve sensory processing (e.g., focusing in noisy classrooms). The combination of sensory sensitivities and motor difficulties can affect confidence and participation in both academic and social settings.

  • Daily Living Skills: Everyday tasks like cooking, cleaning, and self-care can become overwhelming due to the sensory and motor challenges in AuDHD. Sensory overload might make it difficult to shop for groceries, while motor coordination issues can make tasks like brushing teeth or preparing meals exhausting.

in essence...

The sensory and motor challenges of AuDHD are intricate, multifaceted, and unique. AutDers often face conflicting sensory needs—balancing between hypersensitivity and the craving for stimulation—alongside motor coordination issues that affect both fine and gross motor skills. These challenges can lead to frustration, fatigue, and difficulty navigating daily tasks, learning, or physical activities.

Neurodiversity Misattribution

https://journals.sagepub.com/doi/full/10.1177/13623613241237871

While neurodiversity is popularly attributed to Judy Singer, it was in fact a collective effort of many autistic activists in the 1990s. A correct in attribution is overdue.

"For some time, the coinage and theorizing of the concept of ‘neurodiversity’ has been attributed to Judy Singer. While Singer published one early book chapter on the neurodiversity movement in 1999, she was only one of many working on theorising neurodiversity, and certainly not the first. In fact... ‘neurological diversity’ or ‘neurodiversity’ concept – and body of theory surrounding it – was collectively theorised and developed by autistic activists, primarily in the autistic community email list Independent Living in the mid-1990s. While much of this earlier theorising, and that which followed, has been lost due to being on now defunct emails lists, forums, blogs, and so on, in our view, it is important to clarify the multiple origins of the concept. This allows us to correctly show that neurodiversity theory arose and was developed collectively among autistic activist communities, rather than originating with any individual"

Its like the way I had attributed "inspiration porn" to Stella Young, who had used it a Ted Talk and thus popularized it. But the term was coined by comedian Maysoon Zayid. Thanks to disability rights activist, Rebecca Cokley who knows both was nice enough to correct the attribution.

Interoception and Autism

Interoception refers to the perception and awareness of internal bodily states. It involves the ability to sense and interpret physiological signals originating from within the body, such as hunger, thirst, heartbeat, temperature, respiration, and the need for bodily functions. Interoception is crucial for maintaining homeostasis and overall well-being as it allows an individual to respond appropriately to bodily needs and emotional states. This internal sensory system plays a significant role in emotional experiences and self-regulation by linking physical sensations with emotional responses.

Relevance to Autism

For example, interoceptive awareness includes the ability to feel a racing heartbeat when anxious or to recognize a sensation of fullness to prevent overeating. In autism, this sense may be heightened or diminished, leading to unique challenges such as difficulty in identifying states of discomfort or illness, or misinterpreting signals of emotional changes which are critical in social interactions and personal health management. Moreover, the role of interoception in autism extends to fundamental daily activities; it influences everything from toilet training—where recognizing the need to urinate can be delayed or unclear—to managing anxiety and stress levels in response to overstimulation or environmental changes. These distinct interoceptive experiences can significantly affect how individuals with autism recognize and communicate their needs and emotions, thus requiring tailored strategies that address these sensory processing differences to enhance their quality of life and autonomy."

TedX

It was a such an honor and privilege to get the opportunity to give a TedX Talk.
This is the recording of my TedX Talk: https://www.youtube.com/watch?v=e87-3xydg58


News coverage of the event by the Frist Center. 


In the spirit of spreading ideas, TEDx is a program that brings people together to share a TED-like experience. At a TEDx event, live speakers and TEDTalks videos combine to spark profound conversations and connections in a small group.


The upcoming TEDxFolsom High School Youth event promises to be an inspiring experience. The speakers are prepared to unleash their inner selves, share their stories and emotions, and spread the one idea everybody has been waiting for. They aim to bring change to the community and show their spark to the world. The event will allow high school students to stand alongside adults and unleash their hidden power.

One of these speakers will be FCAI’s own Hari Srinivasan, Neurodiversity Inspired Science and Engineering Fellow. This event is open to the public, and tickets are available here.


Apr 20, 2024 (In-Person) in Folsom, CA
TedX Event: https://www.ted.com/tedx/events/56378
Tickets: https://tedxfolsomhighschoolyouth.ludus.com/index.php
Hari Srinivasan: "Pebbles in the Pond of Change"



 

FCAI would like to congratulate Hari Srinivasan on his recent keynote address an the Duke Center for Autism and Brain Development

 

FCAI would like to congratulate Hari Srinivasan on his recent keynote address an the Duke Center for Autism and Brain Development’s 2023-24 Autism Seminar Series on April 3, 2024. Hari is a self-advocate, a PhD student in neuroscience at Vanderbilt University, a Paul & Daisy Soros Fellow, and a Neurodiversity Inspired Science and Engineering fellow at FCAI, among other accomplishments. His presentation, “Redefine the Table,” was attended by more than 275 individuals from 12 countries, marking one of the highest attended seminars in the 10-year history of the Duke Autism Seminar Series. Through his personal narrative and professional insights, Hari illuminated the critical need to redefine the conversation around autism and disability to foster true belonging, inclusivity, and meaningful support across the lifespan. His advocacy for embracing multiple aspects of disability and challenging perspectives around disability to achieve equity in social, medical, and research spaces is commendable and inspiring.



Reclaiming "Person with Autism"

I'm reclaiming the use of "person with autism" and am not offended by it. It is part of who I am. 

When you reclaim language as a positive, it cannot be used against you. Others lose the power to use it as a negative against you.

I am both 'autistic' and a 'person with autism'



IFL v PFL

Identify First Language (Autistic/ disabled) v Person-First Language (Person with Autism, Person with Disability) 

Seriously, with the amount of airtime spent on this topic,  one would think this is the only and primary issue facing autism. Can we move on already and just accept both. We have SO MANY CRITICAL ISSUE TO FOCUS ON and this is not one of them. 

Let me remind you, person-first-language was literally the language of the disability rights movement (DRM). Without that, none of us can even move about in society. All our legislation uses this language

  • Americans with Disabilities Act
  • Individuals with Disabilities Education Act
  • United Nations Conference on Rights for Persons with Disabilities (UNCRPD)
These laws were meant to uplift us. So how can "person with autism" be degrading?

I was told that this was projects fragmentation, a separation of our autism from our human self. In fact if that is even possible, there are aspects of my 'undesirable parts of autism" that I would very much like to distance from, if that is even possible - like my behavioral challenges, mood swings, my OCD, my health issues. So that argument does not fly because I can't even separate those even if I want.  So why are we having these circular arguments. 

And if we think something is undesirable, instead of fighting it, let's take control of the narrative, let's own it, let's rebrand and repurpose it. When you reclaim language as a positive, it cannot be used against you. Others lose the power to use it as a negative against you.

The wheelchair user community have done this already - they have turned "cripple" into the very positive "crip" (Krip Hop, Crip Camp the Oscar nominated movie). That is such a BRILLIANT move and I am in deep admiration. I've heard one of my disabled professors, Dr Victor Pineda, being referred to as a "super-crip" by Stuart James (Exec Director of  Berkeley Center for Independent Living) and I thought that term was so super cool. 

Autism was a latecomer to the DRM and we adopted IFL later as well. 

If a person wants to use IFL, that's fine too.  
If a person want to continue using PFL that's fine too. 

I would say let's use and encourage both. 

Why is this important?

A few years back there was an NYT article that suggested re-introducing state run institutions. I think you will agree that institutions is "BAD" on so many levels -  negates the entire DRM efforts which fought to get people out of institutions. There was a twitter storm over the article. But the criticism was NOT about INSTITUTIONS, but rather over the fact of "person with autism" used in the article. 

How is "person with autism" more important than re-introduction of institutions? 

What is this obsession of the autism community with a narrow focus on this one little issue of person-first over everything else. Our priorities are SO MESSED UP. 

I understand that people can have preferences but seriously it does not merit the amount of discussion time it currently gets. 

LETS ENCOURAGE AND ACCEPT BOTH. Let's make both as positive for us, so we don't have to keep circling this one issue. 

Lets' move onto the real issues in autism please. 

I'm reclaiming the use of "person with autism" and am not offended by it. It is not diminishing who I am. I am both 'autistic' and a 'person with autism'

- by Hari who is both "Person with Autism" and "Autistic"

PS: Language usages
Brits say : I'm going to visit my friend"
Americans like to say: "I'm going to visit with my friend"
 
Did the additional "with" change the meaning. 

My Duke Keynote was one of the highest attended in the 10 year history of Duke Autism Summer Series

 WITH MORE THAN 275 ATTENDEES FROM 12 COUNTRIES, THE PRESENTATION WAS AMONG THE HIGHEST ATTENDED IN THE 10-YEAR HISTORY OF THE DUKE AUTISM SEMINAR SERIES


On April 3, 2024, Hari Srinivasan presented the keynote address in the Duke Center for Autism and Brain Development's 2023-24 Autism Seminar Series, in recognition of Autism Acceptance Month.

A self-advocate, Srinivasan is a PhD student in neuroscience at Vanderbilt University, an alumnus of the University of California, Berkeley, a Paul & Daisy Soros Fellow, a NISE fellow at the Frist Center for Autism & Innovation at Vanderbilt University, and a public member of the Interagency Autism Coordinating Committee. He is a member of the Duke ACE Advisory Committee.

In his presentation, "Redefine the Table," Srinivasan illuminated the critical need for autistic individuals not just to sit at the table where autism is discussed, but to fundamentally redefine the table itself. He invited participants to consider a shift in perspective from binary views of autism to a more integrated approach that recognizes the complex, multifaceted experiences of autistic individuals.

Through his personal narrative and professional insights, Srinivasan underscored the importance of redefining the conversation around autism and disability to foster true belonging, inclusivity, and meaningful support across the lifespan. This redefinition calls for embracing multiple aspects of disability.

He advocates for both strengths-based opportunities as well as challenge-based solutions, acknowledging the diverse needs and potential of autistics across the spectrum. His talk challenged the audience to reconsider their perspectives around disability to achieve equity in social, medical, and research spaces.

The role of the autistic in research

Thoughts around autistic people leading research rather than only participate by giving accounts of lived experiences.

I think rather than talking about one autistic or neurotypical being the leader, which seems to imply a position of dominance by one group, we should be thinking more in terms of what Judy Heumann used to term as Collaboration Cooperation. Both disabled researchers and non disabled researchers need to work together for meaningful change. And most research is a team effort anyway. What the non disabled researchers bring to the table is a lot of experience in how to go about research and they’ve had a couple of centuries of head start in this. When you combine this with collaboration and leadership of autistic researchers you get the following added benefits.
  1. Autistic insights through a nuanced understanding of autistic experiences that cannot be fully captured by observation or second-hand accounts. 
  2. Innovative approaches through distinct cognitive and perceptual experiences. This can lead to innovative research methods and findings that might be overlooked by non-autistic researchers. 
  3. Increased relevance and application towards practical and relevant issues. 
  4. Empowerment and representation as autistics in leadership, challenges traditional narratives of them only being research subjects. 
  5. Reducing bias in data interpretation from a neurotypical lens. 
  6. Building trust among autistic participants that this research is likely to be ethical and beneficial.  
  7. Policy and practice impact as autistic researchers are more likely to advocate for changes that directly improve the lives of autistics. Their leadership in research can influence policy, educational practices, and therapeutic approaches in ways that are more aligned with the needs of the autistic community.

Upcoming

 

If you missed Hari Srinivasan at our Duke seminar series, there's another chance to hear more from him on a related topic in this webinar next week.


Insights and more

Cell Press and The Lancet invite you to a free virtual panel examining hashtagneurodiversity within the scientific community.

Through a series of engaging presentations and a live Q&A, this event will feature insights from leading experts. Panelists Mary Doherty (University College Dublin), Hari Srinivasan (Vanderbilt University) and Axelle Ahanhanzo (LAUDACE) will offer insights into making spaces safer for neurodivergent people, discuss intersectionality and neurodivergence, and unpack the importance of evolving scientific language to reflect lived experiences while ensuring rigorous scientific investigation.

Gain a deeper understanding of the value of neurodiversity in propelling scientific progress.
Register today: https://lnkd.in/eMyh9dZe

hashtagscience hashtaginnovation hashtagresearch

 

Solutions not more talk or more labels

I would like to see ACTION on ACTUAL SOLUTIONS - communication, biomedical physiology (physical/mental health), sensorimotor, policy, funding, myriad equity of access issues. Level the playing field so that ALL autistics can make use of opportunities. Thats quality of life.

Simultaneously reclaim and destigmatize existing labels so they can’t be used against you, instead of airtime and resources creating more and more new labels /terminology and then more airtime arguing about which is good/bad.