Sensory alterations have been shown to be a central clinical component in autism spectrum disorder (ASD), not only as symptomatic adjuncts but also as structuring elements of the behavioral picture itself. According to Posar and Visconti (2018), these manifestations include patterns of hyporeactivity, hyperreactivity, and sensory seeking, as well as a possible fourth pattern—enhanced perception—which highlights the phenotypic complexity of sensory disturbances in autism.
Although these alterations are not exclusive to ASD, as they also appear in conditions such as intellectual disability, their prevalence and functional impact are significant in children with autism. It is estimated that the majority of these individuals have some type of sensory disturbance, often invisible to conventional clinical eyes due to the communicative limitations characteristic of the disorder. This, in itself, imposes the need for formal and regular assessments of sensory function as an essential part of the neurobehavioral approach for these patients (Posar & Visconti, 2018).
Recognizing these sensory patterns isn’t just diagnostic: it has direct implications for therapeutic management and environmental adaptation strategies. An atypical response to sensory stimuli—for example, intolerance to specific sounds, fascination with rotating lights, or apparent indifference to pain—can generate a cycle of distress and behavioral disorganization. Children who cannot verbalize the discomfort resulting from intense sensory stimuli tend to express it through agitation, self-harm, or social withdrawal. These reactions are often misinterpreted as disruptive behaviors, when in fact they stem from altered sensory processing.
The literature presented by the authors reinforces the role of impaired multisensory integration as a relevant explanatory hypothesis for the core symptoms of ASD. Rather than isolated deficits in sensory channels (such as hearing or vision), they suggest a failure in long-range neural connectivity, compromising the ability to combine stimuli from multiple sensory modalities. This integration dysfunction may be one of the keys to understanding the challenges in social communication and repetitive behaviors that define the disorder (Posar & Visconti, 2018).
In terms of intervention, the distinction between child-centered approaches—such as sensory integration therapy—and those focused on the environment, such as the use of unisensory strategies (therapy balls, weighted vests) stands out. The former have shown greater effectiveness in randomized clinical trials, promoting gains in motor planning, joint attention, and social skills. In contrast, unisensory approaches have demonstrated limited results in terms of clinical efficacy (Posar & Visconti, 2018).
There is still a thoughtful aspect to consider: should sensory alterations be viewed as comorbidities of ASD or as central dimensions of the disorder? Posar and Visconti adopt a cautious stance, acknowledging that the data do not yet allow for a definitive conclusion. However, given the frequency and intensity of the effects of these alterations on the daily lives of individuals and their families, it seems reasonable to treat them as relevant clinical pillars, the neglect of which compromises both diagnosis and intervention.
In clinical practice and research, this implies the urgent need for assessment methods that transcend parental reports and strive, whenever possible, to capture first-person sensory experiences, despite the communicative limitations imposed by ASD. Furthermore, it is necessary to continue investigating the neurobiological underpinnings of these changes, using techniques involving genetics, functional neuroimaging, and brain connectivity, so that more precise and personalized interventions can be developed.
Reference:
POSAR, A.; VISCONTI, P. Sensory alterations in children with autism spectrum disorder. Jornal de Pediatria (Rio J.), v. 94, n. 4, p. 342–350, 2018. DOI: https://doi.org/10.1016/j.jped.2017.08.008. Available at: https://www.jped.com.br. Accessed on: June 20, 2025.
