Many kids with Asperger’s (AS) and High-Functioning Autism (HFA) struggle with sensory processing challenges, and some have Sensory Processing Disorder (SPD). SPD is a condition in which the child’s brain has trouble receiving and responding to information that comes in through the senses.
The symptoms of SPD include the following:
• can’t crawl "on all fours"
• can’t hold self upright in walker, high chair for more than a few minutes
• can’t latch on, or suckle to nurse
• cries when bathed
• difficulty lifting head when on tummy
• doesn’t like baby swings, or riding in car
• doesn’t like to be cuddled, or will not let you put her down
• extremely active or extremely quiet
• frequently make fists
• may only sleep when swinging or riding in car
• must have absolute quiet to settle down/or must have certain sounds
• screams hysterically when hungry, wet, cold, or hot
• seems to never sleep, doesn’t develop sleep patterns
• struggles when changed
• takes an unusually long time to nurse or finish bottle
• tenses, or cries when held in space
• uses soldier crawl, or scoots rather than use arms to bear weight
• acts claustrophobic when slightly stuck in clothes
• acts out aggressively when touched, provoked, or upset
• afraid no matter what consolation you give
• afraid of dark
• afraid of drain in tub
• afraid of falling in toilet
• afraid of new places, people
• always has shoes on, or never leaves them on
• bites fingers and tongue while eating
• can’t hold pencil or crayon in correct grip
• can’t pedal tricycles, bikes, scoot type toys
• can’t sit through a meal
• can’t snap, zip, buckle, or tie
• can’t use scissors
• can't get comfortable
• chews with mouth open
• complains food too hot, or too cold
• crashes, crashes, crashes
• cries when fingernails and toenails clipped, or hair cut
• difficulty doing puzzles, Leggos, stacking blocks
• difficulty going up or down stairs
• difficulty guiding utensils to mouth
• difficulty with push and pull toys
• dislikes carbonated drinks
• doesn’t like baths, washing or combing hair
• doesn’t like belts, or anything snug around waist
• doesn’t like certain textures; too crunchy, soft, grainy, or slimy
• doesn’t like feet touched
• doesn’t like sleeves that hit wrist, or high collars
• doesn’t like to brush teeth
• doesn’t recognize need to go potty
• drops food on floor, all over table, unintentionally
• easily frustrated, quick to anger
• falls off of chairs, couches, bed
• falls out of chairs
• fidgets and moves around a lot while sitting
• flits from one activity to another
• food has no taste, or tastes too strong
• grabby, hugs too hard, body slams while playing
• has hard time with spoons and forks
• has trouble dressing self
• hates taste of toothpaste
• hides under furniture
• jumps, jumps, jumps
• legs hang, rather than wrap around someone's hips when carried
• likes certain clothes, usually cotton
• likes cool or very warm baths
• likes to be totally covered, or is constantly removing clothing
• likes very few foods, or will eat anything
• meltdowns in stores, restaurants, public places
• messy eater, dribbles food down chin, or can't stand mess on hands
• over dresses in hot weather, or under dresses in cold weather
• over stuffs mouth, chokes
• poor posture
• potty accidents that go on and on
• prefers picking/grazing through the day, instead of regular mealtimes
• prefers unusually hot, or unusually cold food
• rests head on hands or arms frequently
• seams in clothing or socks bothersome
• seems not to listen
• seems under/over sensitive to pain
• severe separation anxiety
• severe temper tantrums, sometimes many per day
• spills food and drinks frequently
• spins, spins, spins
• strong preference for or against playground equipment
• trouble kicking ball, or catching balloons
• trouble playing with other children
• uses sippy cup long after most children have moved on
• vomits a mouthful when too upset
• walks into walls, corners, people
• wants tags removed
• when excited, over does it, can't calm down
• withdraws into self, zones out
• won't carry objects, seem too heavy
• acts wild when in a group
• bumps into people and things
• can’t complete more than one direction at a time
• can’t follow directions without constant verbal reminders
• can’t judge time
• clumsy, spacey, lazy
• craves/avoids touching
• difficulty hearing adult voices over background sounds
• difficulty with handwriting
• dislikes changes in plans or routines
• doesn’t complete tasks
• doesn’t like loud noises or commotion
• easily distracted
• erratic sleep patterns
• “falls apart” frequently
• forgets shoes, socks, homework, assignments
• has trouble making choices
• hides when anyone comes over
• immature, baby talk, cries over inconsequential things
• inverting/reversing numbers and letters
• leaves the table during meals
• misses when placing objects on table
• overly excited when people come to house
• poor speech, articulation
• poor written work
• reading and math difficulties
• short attention span
• speaks unusually loud/ talks too soft to hear
• stubborn, uncooperative, defiant
• unusually low/high energy
• won't join the group
Children whose bodies need particular types of sensory input tend to do exactly what they need to obtain that input, sometimes in ways parents may not particularly like. The AS or HFA youngster may love to chew on nonfood objects, crash into furniture or other children, hang upside down, jump on the furniture, flap his arms, or spin in circles. This is called “self-stimulatory” behaviors. Some “self-stimulatory” behaviors are an attempt to obtain much-needed sensory input that either revs up or slows down a poorly functioning nervous system. At other times these behaviors act as a coping mechanism until the youngster figures out how to ward off or deal with sensory overload.
Three major challenges for parents and teachers who deal with a child who has SPD are (1) recognizing when the youngster is under-reactive or over-reactive in any given moment, (2) calibrating sensory input to meet her where she is, and (3) providing a “just right challenge” to help her move forward into a “just right” state of being. Fortunately, there are proven techniques for reducing under-sensitivities and over-sensitivities, and modifying tasks and environments to support success while the child builds underlying sensory processing skills. Foremost among these techniques is what’s called a “sensory diet.”
Senses that should be included in a sensory diet include the following:
1. Auditory— Auditory input refers to both what you hear and how you listen, and is physiologically connected with the vestibular sense.
2. Proprioception— Proprioceptive input (i.e., sensations from joints, muscles and connective tissues that lead to body awareness) can be obtained by lifting, pushing, and pulling heavy objects, including the child’s own weight. He can also stimulate the proprioceptive sense by engaging in activities that push joints together (e.g., pushing something heavy), and pull joints apart (e.g., hanging from monkey bars).
3. Smell— Olfactory input comes through the nose and goes straight to the most primitive, emotional part of the brain. So, if your AS or HFA youngster is upset by something being “stinky” – it’s no wonder. Certain odors can stimulate, calm, or send her into sensory overload.
4. Tactile— The tactile sense detects pain, light touch, deep pressure, texture, temperature, and vibration. This includes both the skin covering your body and the skin lining the inside of your mouth. For the AS or HFA child, oral tactile issues can contribute to picky eating and feeding difficulties.
5. Taste— Taste input is perceived by your tongue, but how you interpret or experience it is strongly influenced by your sense of smell.
6. Vestibular— This is the sense of movement centered in the inner ear. Any type of movement will stimulate the vestibular receptors, but swinging, spinning, and hanging upside down provide the most intense, longest lasting input.
7. Visual— Visual input can often be overstimulating for an AS or HFA youngster with sensory issues.
The goal of a sensory diet is to give your AS or HFA youngster the right kind of sensory input in regular, controlled doses so there’s no need for him to resort to undesirable behaviors. For example, rather than bouncing off the walls during lunch, he can bounce for a few minutes on a mini-trampoline before it’s time to sit down to eat. Rather than chewing on a crayon, he can munch on a “Gummi bear.” Instead of crashing into the furniture to get deep pressure stimulation, he can jump into a safely placed “crash pad” or punching bag.
The starting point in creating a sensory diet that meets your AS or HFA child’s unique needs is to look at her behaviors, especially those that are a bit odd. In general, a youngster whose nervous system is “hyper” needs more calming input, while the youngster who is more “slothful” needs more arousing input. While each child’s likes and dislikes are different, activities that are more rapid and less predictable tend to be more alerting – while slow, rhythmic, and repetitive activities tend to be more soothing.
Finding the perfect activity to achieve that optimal state takes some detective work and creativity on the parent’s part. Few kids are always tired or always wired. The right combination of sensory input is something parents will need to figure out together with the child, and preferably with the assistance of an occupational therapist.
Below is a sample sensory diet that was created for Andrew, an 8-year-old youngster with Asperger’s and SPD. A separate program was created for Andrew with the school, including an inflatable seat cushion for wiggling while remaining seated, frequent movement breaks, and providing chewy oral comfort snacks during handwriting class.
Sample Sensory Diet--
In the morning:
- Eat crunchy cereal with fruit and protein
- Jump on mini-trampoline as directed
- Listen to recommended therapeutic music
- Massage back
- Use vibrating toothbrush
- Artwork time (e.g., drawing, clay projects, painting projects, etc.)
- Do ball exercises as directed
- Eat crunchy and chewy snacks
- Go to playground for at least 20 minutes
- Listen to therapeutic music
- Massage feet
- Push grocery cart
- Spinning as directed
- Provide crunchy and chewy foods
- Help with dinner preparations (e.g., mixing, chopping, blending, etc.)
- Help set table
- Warm bath with bubbles and calming essential oil
- Massage during reading time
- Burn scented candle prior to falling asleep
Here is a list of 50 activities to consider when creating your child’s unique sensory diet:
1. Bang on pots and pans.
2. Climb up and down stairs.
3. Create a scrapbook (lots of pasting and working with different textures).
4. Do cartwheels, swim, jumping jacks, and dance.
5. Do jumping jacks, floor pushups or wall pushups.
6. Do wheelbarrow walking, with ankles held.
7. Dress up in fun costumes to get used to the feel of unfamiliar clothing.
8. Drink thick liquids through a straw.
9. Eat chewy or crunchy foods or chew gum.
10. Encourage child to walk barefoot in the grass, sand, or dirt.
11. Encourage play with make-up, face painting, and costumes.
12. Get a firm massage.
13. Get a white noise machine, tabletop rocks-and-water fountain, or aquarium.
14. Go swimming.
15. Go to the beach or sit still and listen to the rain, thunder, etc.
16. Go to the playground and use slides and swings.
17. Have child finger-paint, play with glitter glue, or mix cookie dough and cake batter.
18. Have child hang upside down from playground equipment, do somersaults, or ride a loop-de-loop rollercoaster.
19. Have child play with foamy soap or shaving cream, and add sand for extra texture.
20. Have child vacuum, carry books from one room to another, help wash windows or a tabletop, and transfer wet laundry from the washing machine to the dryer.
21. Have the child sit very quietly and try to identify the sounds he/she hears (e.g., traffic, people taking, planes, etc.) and where it’s coming from.
22. Help child garden and repot indoor plants.
23. Hold the youngster’s arms and spin in a circle as he/she lifts off the ground.
24. Inhale favored essential oils or other fragrances.
25. Jump on a mini-trampoline, bouncy pad, or mattress placed on the floor.
26. Let child run in circles or ride a carousel.
27. Let the youngster drink plain seltzer or carbonated mineral water to experience bubbles in his/her mouth (flavor it with a little juice).
28. Listen to birds singing and try to identify what direction a given bird is calling from.
29. Listen to favorite music with headphones.
30. Listen to natural sound recordings of rain falling, ocean waves, bird songs, etc.
31. Make a “burrito” by rolling child up in a blanket.
32. Play a musical instrument.
33. Play in a sandbox or use a sensory bin filled with uncooked rice and beans.
34. Provide the youngster with a musical instrument and encourage him/her to play and even take lessons.
35. Provide the youngster with frozen foods (e.g., popsicles, frozen fruit) and mixed temperature foods (e.g., hot fudge sundae, hot taco with cold toppings).
36. Put on a play or making a mini movie with a video camera.
37. Rake leaves, push heavy objects like firewood in a wheelbarrow.
38. Ride a tricycle or bicycle.
39. Rock in a rocking chair, glider, or on a hobby horse.
40. Sculpt, sew, weave, crochet or knit.
41. Sit in a quiet “safe space” with soft lighting.
42. Spin on a Sit N’ Spin, Dizzy Disc Jr., or office chair.
43. Squish between sofa cushions to make a “sandwich.”
44. Swing on a hammock.
45. Take a warm bath or shower.
46. Try Sound Eaze CDs that desensitize autistic kids to everyday sounds (e.g., balloons popping, vacuum cleaners, flushing toilets, thunder, barking dogs, alarms, and other sounds these children find distressing).
47. Use a vibrating item (e.g., Squiggle Wiggle Writer, vibrating pillow, or oral vibrator).
48. Use a weighted blanket, vest, lap pad, or other weighted item.
49. Use sandpaper to smooth a woodworking project, or make things out of clay (try using a potter’s wheel).
50. Wear a heavy knapsack or pull a luggage cart-style backpack, or mow the lawn with a push mower.
In summary, a sensory diet is a term used to describe sensory activities that are used to treat children with SPD. If your AS or HFA youngster has symptoms of SPD, your physician can refer you to an occupational therapist for an evaluation. If it is discovered that your child does have SPD, the therapist will create a “menu” of activities. He or she will have you perform these activities in a particular order to create a sensory “meal.” Just like nutritional diets, the sensory diet is designed for your youngster’s sensory needs. The occupational therapist will create a plan of activities for you to do throughout the day.
Note: BrainWorks simplifies the process of creating sensory diets and teaches self-modulation through its use. Click here to join BrainWorks.