This blog was updated on 2/14/2024
The best and most appropriate sensory toys and materials for autism can reveal key details about a child’s abilities and development—but they also can serve as a gateway to a closer and more trusting relationship with the child throughout an evaluation process.
Formal assessments certainly provide essential information, but interesting sensory materials can establish a more authentic connection with the child—or verbally fluent adult—that elicits a better understanding of his or her worldview, according to author Dr. Marilyn Monteiro, PhD.
Monteiro has evaluated more than 4,000 children on the autism spectrum and trained hundreds of educators and clinicians in diagnosing and understanding individuals on the spectrum. She discovered near the beginning of her 30-year career that when conducting an evaluation, behavior rating scales and standardized assessment measures just weren’t enough.
“What was lacking for me was having that instant connection with the child, being able to put the child or teenager at ease, and getting to know what makes their brain tick—what things make their brains alert and engaged, and discovering what they are passionate about,” said Monteiro.
The Centers for Disease Control and Prevention (CDC) estimates that 6% of girls in the U.S. have been diagnosed with ADHD. But advocates think the percentage of girls who have the condition may be much higher. Many won’t be diagnosed until adulthood, if ever.
Board-certified child psychiatrist Loucresie Rupert, MD (pictured right), has a deeper understanding of this diagnostic gap than many, since her specialization in neurodiversity is enhanced by her own lived experience. “I wasn’t diagnosed with ADHD until residency,” Dr. Rupert says. “I went to an internal medicine doctor who specializes in ADHD. It was literally life changing.”
It’s important, she says, to understand why so many diagnoses are missed and so many symptoms are misunderstood.
This article takes a deeper look at the signs of ADHD in girls and women. And Dr. Rupert offers expert guidance on how to improve your ability to detect them.
Sensory Materials can lead to conversation
Monteiro started collecting interesting sensory materials, or what she calls “sensory conversation starters.”
Before the evaluation, she would open her “Mary Poppins bag” containing different objects, materials, and sensory toys, creating a more informal interview with the child. But it turned out to be an “autism conversation,” involving a limited amount of social talking to invite the child to share more.
“When I started doing this, it ended up becoming a formal process because I did it over and over and over again,” Monteiro said. “And I found that during the informal time with the sensory materials, I was able to really get a lot of information about the child’s strengths and differences, how they are using language and communication, their social relationships and how they work with other people and their emotions, what type of three-dimensional thinkers they were, and what kinds of things they were sensitive to.”
Monteiro eventually developed this process into her widely-used and recently updated autism evaluation method, the MIGDAS-2, which relies on descriptive conversations from multiple sources to build a highly personalized profile of the individual, linked to customized intervention strategies.
Obtain key information through materials
“Sensory materials also allow evaluators to observe when the individual has an aversion or sensitivity to sensory input,” said Monteiro, who also conducts training on how to communicate with families during the evaluation process.
The sensory-based conversation, using sensory materials with distinctive sensory properties, provides a powerful way to distinguish between children with ASD whose brains organize best while focusing on objects and typically developing children whose brains thrive on social communication.
Sensory materials can also elevate the quality of an evaluation with verbally fluent adults. According to the MIGDAS-2 manual, interviews with verbally fluent adults work best when conversation is the focus. However before the interview, placing several sensory objects where the adult will be sitting allows the practitioner to observe the individual’s use of objects as self-regulation tools, in addition to collecting self-report information during the interview.
To promote a productive diagnostic interview with verbally fluent adults, Monteiro suggests sensory materials that include novel fidget items, such as magnets for manipulation (e.g., the X-Ball and Ball of Whacks), the thunder tube percussion instrument, and assorted sensory stress balls.
The following list contains sensory materials that have been shown to provide some form of clear sensory input. They can provide a way for the individual to set up repetitive sensory routines to obtain visual, auditory, or tactile input.
When searching for sensory materials, Monteiro looks for objects that fall into one of the following categories:
- Visual cause-and-effect materials: Water games, spinning light-up materials that require the individual to push a button to operate them, magnetic puzzles, and other materials of this nature.
- Noisemakers: Thunder tube percussion instrument, plastic tubes that make a squawking sound when they are tilted back and forth, musical materials, and plastic microphones that produce an echo when spoken into.
- Tactile objects: Sensory stress balls with various textures and animal-shaped materials that vibrate.
- Science objects: Magnets, a robot arm that can grasp objects, a small robot that lights up and moves, and an expanding sphere.
- Alternatives: Books, figurines, or photos of popular cartoon or video game characters available to trigger the child’s specific areas of interest.
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Benefits of Sensory Toys and Materials for Autism Evaluations
In general, toys in clinical and therapeutic settings can help relieve anxiety and build bonds between health professionals and children (Ciuffo et al., 2023). Using sensory toys and objects in autism evaluations can have benefits like these:
1. Reduced Anxiety and Stress: Unfamiliar places and social interactions can be stressful for some autistic children. Sensory toys can have a distracting and calming effect on children in clinical environments, studies show. In fact, some hospital emergency rooms have sensory kits on hand to improve the experience for autistic children. Kits may include light-up wands, push-pop bubble toys, squeezable balls, and other toys (Roy et al., 2022).
2. Improved Focus and Engagement: Play settings and materials can influence engagement, studies show. In a 2022 study involving 70 autistic preschoolers, researchers compared how engaged the children were with their caregivers and with objects in two different settings. One environment offered symbolic toys. Another offered toys that stimulated gross motor movements, such as trampolines, yoga balls, and spinning chairs. They found that children paid more attention to the movement toys and engaged more often with their caregivers in the motor stimulating setting (Binns et al., 2022).
3. Individualized Assessment: In studies, around 74% of autistic children respond to sensation in atypical ways (Kirby et al., 2022). Using sensory toys can give you insight into their sensory needs and preferences. In a study involving 41 autistic children in a multi-sensory room, researchers found that children with different sensory profiles were drawn to different toys. For example, children with sensory sensitivities opted for the tactile board over the bubble tube, which vibrated, made sounds, and lit up. They also noted that children with sensory-seeking profiles spent less time in sensory seeking behaviors when they could interact with tactile boards and sound-light boards. In this study, the two most popular toys emitted both light and sound (Unwin et al., 2023).
4. Behavioral Observation: The Centers for Disease Control and Prevention say a comprehensive evaluation is “a thorough review of how a child plays, learns, communicates, acts, and moves” (CDC, 2023). Observing how individuals interact with sensory toys can provide valuable insights into how they play, act, and move. It may also provide you with information about the way a child communicates. This data contributes to a fuller, richer picture of the child.
People respond differently to sensory features in toys because their sensory profiles are unique. Using sensory toys in an evaluation can help you build a holistic picture of a person’s strengths and the support they may need moving forward.
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This list of sensory materials originally appeared in Marilyn Monteiro’s 2010 book Autism Conversations: Evaluating Children on the Autism Spectrum through Authentic Conversations. Learn more about the MIGDAS-2, which includes updated information for building a sensory-based materials kit.
Research and Resources:
Binns, A. V., Casenhiser, D. M., Shanker, S. G., & Cardy, J. O. (2022). Autistic preschoolers' engagement and language use in gross motor versus symbolic play settings. Autism & Developmental Language Impairments, 7, 23969415221115045. https://doi.org/10.1177/23969415221115045
Centers for Disease Control and Prevention. (2023). Community report on autism 2023. https://www.cdc.gov/ncbddd/autism/pdf/ADDM-Community-Report-SY2020-h.pdf
Ciuffo, L. L., Souza, T. V., Freitas, T. M., Moraes, J. R. M. M., Santos, K. C. O. D., & Santos, R. O. J. F. L. D. (2023). The use of toys by nursing as a therapeutic resource in the care of hospitalized children. Revista Brasileira de Enfermagem, 76(2), e20220433. https://doi.org/10.1590/0034-7167-2022-0433
Kirby, A. V., Bilder, D. A., Wiggins, L. D., Hughes, M. M., Davis, J., Hall-Lande, J. A., Lee, L. C., McMahon, W. M., & Bakian, A. V. (2022). Sensory features in autism: Findings from a large population-based surveillance system. Autism Research, 15(4), 751–760. https://doi.org/10.1002/aur.2670
Roy, M., Kinlin, C., & MacEachern, S. (2022). Implementation of a sensory toolkit in the emergency department for children with autism spectrum disorder. Paediatrics & Child Health, 27(Suppl 3), e23. https://doi.org/10.1093/pch/pxac100.048
Unwin, K. L., Powell, G., Price, A., & Jones, C. R. (2023). Patterns of equipment use for autistic children in multi-sensory environments: Time spent with sensory equipment varies by sensory profile and intellectual ability. Autism, 13623613231180266. Advance online publication. https://doi.org/10.1177/13623613231180266
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