The second edition of Olga Bogdashina’s classic book has just been released. The same is entitled “Sensory Perceptual Issues in Autism and Asperger Syndrome- Different Perceptual Worlds”. It can be bought from Amazon for $24.95 and has received 5 stars in reviews. I was honored in having been asked to write the preface for the same which I reproduce below.
Olga has been the first person to pay close attention to sensory issues in autism. Reading the book, full of quotes by patients, was a learning experience. It is already a classic in the field and a must read for anybody interested in autism. I have to thank Olga for having the courage to tackle the hard problems. Her foresight was not the result of having stood on the shoulders of giants. This was a field she plowed by herself. This is typical of Olga, challenging herself to do what others have been afraid to pursue. In other books Olga has similarly tackled the hard questions; what is “normal” and “abnormal” in “Edges of the Known World” and concepts of spirituality in “Autism and Spirituality”.
The photo was taken from a question and answer session regarding autism with academicians and other government officials in Russia. Olga was seated to my left. It was easy to feel at ease when you have Olga by your side.
I often tell my fellows that autism is a pervasive developmental disorder because it covers so many different areas of cognition. In order to become proficient in it, you have to learn the whole of psychiatry, e.g. intellectual disability, mood disorders, stereotypies. Yet for autistic individuals with sensory problems the term pervasive acquires a different meaning. It is pervasive because sensory problems are with you every minute of every day. In effect, sensory disorders color all aspects of your life experiences. You can’t shake the ramifications of sensory problems as they mold your behavior, interrupt your sleep, hamper your socialization, shift your attention, and obstruct any attempts at learning. Sensitivity to light, sound, and touch is more debilitating than those disabilities related to social interaction and communication. Indeed, the overwhelming and enduring tidal wave of sensations garnered by a hug may contribute to a ricocheting cascade leading from socialization problems to mood disorders. You can’t afford to socialize while engaging in a hostile environment that assaults your senses.
Sensory disorders in autism are frequently reported but otherwise little understood or appreciated. In this regard, Olga Bogdashina’s book and views antecede the DMS5, the Diagnostic and Statistical Manual fifth edition, on the importance of sensory problems in autism. This book portrays the underlying deficits to sensory problems as aberrations in the cortical circuitry and the interrelated connectivity between brain areas that are themselves molded during brain development. According to Olga, and I readily agree, sensory phenomena in autism have a biological substratum.
Even though the importance of the biomedical dimension is readily gathered from this book, Olga similarly emphasizes the humanistic experience of the individual patient. Patients need to be able to explain their ailments,- you can’t undercut their claims. “Sensory Perceptual Issues in Autism and Asperger Syndrome” creates order out of chaos by emphasizing the subjective statements of individuals with autism. In effect, the book is an invitation to sit and listen to the experiences of persons in the autism spectrum. Dr. Bogdashina stresses the meaning that life experiences provided to the person with autism rather than the perception attached to autistic behaviors by a physician. This is in effect the best framework to understand symptom burden at the level of the individual. As Olga advises, “boundaries of neuroscience are changing as the distinction between sensory and cognitive functions become increasingly unclear”.
One of the salient aspects of this book is the discussion about potential avenues for treatment. Many of these interventions are commonsensical; as Dr. Bogdashina states, “We accept that we cannot cure blindness and we do not waste time and effort trying to teach visually impaired children to recognize colours. We see our task as helping them function using compensatory strategies, and adjusting the environment to make it easier for them to orient in space”. The first step is to identify the underlying cause(s) of sensory problems for each individual. This treatment is individualized and often requires a one-to-one intervention with a therapist wherein patients are kept informed about all aspects of their care. Many of these interventions are approaches to health care that are not currently considered to be part of conventional or mainstream medicine. Successful outcomes of these interventions will show that individuals are calmer, sleep better, exhibit reduced tactile defensiveness, and may lead to reduce dosages of other medications. Moreover, some of these interventions promote the child’s feeling of control over their otherwise pugnacious environment.
Olga Bogdashina is a teacher, lecturer, researcher, and an author of over one dozen books on autism. She has directed a first day center for autistic children in the Ukraine and is the motive force behind the International Autism Institute in Siberia. She is considered a rock star of the special needs education movement in Russia. Moreover she is also a mother of an adult son with autism. In this regard Olga not only understands the scientific literature but also has privileged access to the way an autistic person thinks and behaves the way they do.
There are always two ways to look at things: the non-autistic way and the autistic way. The task for the reader is to understand the second way; to gain understanding by thinking the way an autistic person does. Overall this is an excellent book, a must read for anybody interested in sensory problems and autism.