HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

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Sensory Meltdowns in Kids on the Autism Spectrum

“Why is my autistic (high functioning) son so sooo sensitive to certain clothing? He refuses to wear jeans and doesn’t like certain shoes and socks. I’ve made the mistake of forcing him to wear some of these things in the past, which resulted in a HUGE meltdown. He will react to certain clothing in the same way someone might react to accidently smashing their thumb with a hammer while trying to drive a nail. He also has a very very limited diet because he will gag on certain foods (e.g., anything green). And he has a startle response whenever a loud unexpected noise occurs (e.g., the blender). Any suggestions on how to work around these problems?”

Sensory meltdowns are not uncommon for children with High-Functioning Autism (HFA) and Asperger’s (AS). A sensory meltdown is a reaction to feeling overwhelmed due to one or more of the senses becoming overloaded with too much information. The ruckus of an amusement park, the hustle and bustle of a back-to-school shopping trip, or the noise and chaos of a crowded school hallway can result in more sensory information than the child can process at one time.

Examples of sensory issues and intolerance in the HFA or AS child include the following:
  • unable to listen to someone speak or carry on a conversation in noisy or busy places
  • overly fearful of swings and playground equipment
  • may walk around acting deaf because he has had to tune out the excessive noise
  • may prefer certain textures of clothing (e.g., soft, loose cotton)
  • may be overwhelmed with new clothing that his body hasn’t become accustomed to
  • hypersensitive to certain visual stimuli (e.g., fluorescent lights) 
  • fearful of surprise touch or crowds
  • extreme response to sudden, high-pitched, loud, or metallic noises (e.g., flushing toilets, clanking silverware, echoing noises in a school gym)
  • fear of climbing or falling, even when there is no real danger
  • doesn’t like his feet to be off the ground
  • difficulty tolerating certain textures, colors, or tastes of food
  • avoids hugs and cuddling, even with parents
  • startle response when touched 
  • doesn’t enjoy a game of tag
  • avoids standing in close proximity to others

Difficulty with Prediction and Anticipation—

For a non-autistic child, unexpected stimuli are relatively predictable and anticipated. For example, the child may expect a loud noise when seeing someone using a hammer, but not when a pillow falls on the floor. He may anticipate a hug when his grandmother is approaching him with open arms. When his mom starts the vacuum cleaner, the noise may surprise him, but he quickly adapts to it. In other words, for the “typical” child, the world is reasonably predictable – particularly in the near future punctuated only by brief surprises.

On the other hand, the HFA or AS child has difficulty with prediction and anticipation. To her, a loving hug from grandpa may feel like a shocking squeeze, the ring of a door bell may sound deafening, and the first-time taste of spicy food may feel like fire on the roof of the mouth. The child’s weak predictive ability makes many daily events very stressful, which often contributes to a high level of anxiety.

Poor Adaptive Adjustment—

Poor adaptive adjustment also contributes to the HFA or AS child’s hyper-sensitivity to “constant” stimuli (i.e., stimuli that is not a sudden surprise, such as background noise in an airplane, florescent lighting in the classroom, skin pressure from clothes, etc.). The non-autistic child adapts to such stimuli because she can predict their persistence, and as a result, she is able to ignore the stimuli. This “adapting and ignoring” skill helps the “typical” child to label background stimulations as “unimportant.”

Conversely, the child on the autism spectrum has difficulty adapting and ignoring. An obnoxious background noise (e.g., noisy school cafeteria) is stressful throughout the entire lunch period. He simply does not have the ability to protect himself from painful environmental stimuli (i.e., shutting it out of consciousness).

It may seem as though your HFA son plans to “misbehave” simply to get on your nerves, but that's probably giving him too much credit. Young people on the spectrum usually don't have evil plans to frustrate or embarrass their parent. Sensory meltdowns often look like tantrums, but there is a major difference between the two.

Identifying a Meltdown—

Meltdowns are triggered by a fight-or-flight response, which releases adrenaline into the blood stream, creating heightened anxiety and causing the HFA or AS youngster to switch to an instinctual survival mode. Meltdowns are (a) often triggered by transitions (e.g., going from class to class, change in topic, change in teachers, etc.), novel situations, or sudden change; (b) time-limited; (c) often caused by sensory or mental overload, sometime in conjunction with each other; (d) a reaction to severe stress, although the stress may not be readily apparent to the parent or teacher; and (e) associated with cognitive dysfunction and perceptual distortion.

Warning signs of an imminent meltdown may include stuttering or showing pressured speech, repeating words or phrases over and over, perseverating on one topic, pacing back in forth or in circles, self-stimulatory behaviors (e.g., flapping hands), extreme resistance to disengaging from a ritual or routine, difficulty answering questions (cognitive breakdown), and becoming mute.

Tips for Managing Sensory Meltdowns—

1. You will need to consider the level of “sensory pollution” in your HFA son’s environment (e.g., several conversations in the same room, plus ceiling fans blowing, plus florescent lights buzzing, plus people moving around).  Understanding the way your son experiences the world will help you to respect his attempts to survive in a “sensory-unfriendly” world. If you understand how he experiences the world and how he interprets what he sees, hears, feels, etc., you can create a sensory-friendly environment in accordance with his perceptual abilities and deficits.

2. The visually-based program entitled “How Does Your Engine Run: The Alert Program for Self-Regulation,” seems particularly well-suited to the needs of young people on the autism spectrum. The program was designed to help “special needs” kids recognize their sensory needs, and teaches them to recognize their level of alertness and compare it to task demands. If the two do not match, the youngster (after completing a series of lessons) is taught to adjust his arousal level to match task demands. To accomplish this, there are a variety of interventions grouped into 5 categories: aural, movement, oral, touch, and visual.

3. Certain colors used on the walls can set the tone for alertness (e.g., red, orange, yellow). Try to minimize these colors in the home (especially in your son’s bedroom). Earthy, neutral tones are best for reducing over-stimulation. Also, accents of purple, blue, or green can be calming.

4. When your son has a sensory meltdown at home, there are several items that may bring immediate comfort, thus breaking the sensory-overload cycle before it gathers enough steam to turn in to a meltdown. For example:
  • favorite video or song
  • massage seat
  • body sock
  • chamomile tea 
  • deep hugs
  • sandwiching between two body pillows
  • ear, hand or foot massage
  • giant exercise ball for sitting and bouncing
  • handheld massage ball
  • heating pad 
  • lavender essential oil or chamomile essential oil
  • massage jet for the bathtub 
  • mini-trampoline
  • rocking chair
  • swing
  • slide
  • climbing structure
  • silly putty
  • play dough 
  • weighted blanket or vest
  • wooden foot massager

5. When you and your son are out and about, carry a portable “sensory toolkit” for situations that may cause sensory-overload.  Items in the toolkit could include the following:
  • a stuffed animal
  • baseball cap or wide-brimmed hat
  • change of clothes (e.g., long-sleeved t-shirt, sweatshirt, sweatpants, etc.)
  • chewy snacks (e.g., beef jerky, raisins)
  • hand lotion
  • ice-cold juice box with a straw
  • lip balm
  • soft fabric (e.g., velour) for rubbing on hands
  • soundproof headphones
  • squeeze ball 
  • sunglasses

6. HFA and AS kids need an environment where they can retreat to when feeling over-stimulated and ready to have a meltdown. Thus, allow your son to have his own sensory-friendly area – one with decreased sensations, comfortable seating (e.g., bean bag chair, large floor pillows), noise-canceling headphones, picture books, etc.).

7. When creating a sensory-friendly environment, consider the following senses: visual, vestibular (i.e., balance), touch and pressure, taste, proprioceptive (i.e., space), olfactory (i.e., smell), and auditory. The questions parents should ask themselves when trying to create a sensory-friendly environment include the following:
  • Are curtains, carpets and furnishings patterned?
  • Are there any smells from indoors that can cause distress (e.g., cleaning products, perfumed products, foods)?
  • Are there any smells from outside that permeate through the walls, windows or doors?
  • Are there items to provide different feelings on the skin (e.g., sand or water)?
  • Are there items to provide pressure if needed (e.g., wooden massagers)?
  • Are there opportunities for swinging, to balance on beams or boards, or to bounce or climb?
  • Are there regular external sounds (e.g., traffic, dog barking)?
  • Are there regular internal sounds (e.g., clocks ticking, refrigerators humming)?
  • Is it possible to reduce external sounds from permeating to the inside?
  • Is there a way of reducing unwanted sounds inside the home?
  • Is there an area that provides for different textures to be felt or stroked?
  • What colors are the walls?
  • What is the lighting like in the rooms, both natural and artificial?

8. As much as possible, try to “optimize” your home environment to meet the specific sensory needs of your HFA son. For example:
  • Allow him to wear sunglasses outside or carry them with him whenever he goes out in public.
  • Avoid using strong scented candles or air fresheners.
  • Avoid wearing perfume or colognes.
  • Consider diffused lighting to reduce glares.
  • Consider using carpets in rooms to help reduce noise intensity.
  • Don’t force your son to eat something or threaten to keep him at the dinner table.
  • Eliminate any lights that flicker.
  • Give your son earplugs to take with him when he is out in public to cope with any unexpected auditory stressors.
  • Keep television and radio noise at a low level.
  • Limit the number of objects or materials hanging on walls.
  • Make use of natural lighting as much as possible.
  • Make a variety of sensory toys and activities accessible in your home (e.g., stress balls, chew toys, sand box, boxes of different types of fabric, vibrating toys, exercise balls, etc.).
  • Only use soft clothing or textures your son prefers. 
  • Remove all tags from clothing.
  • Use odor-free cleaning products.
  • Use visual schedules and other decor that remain in predictable, consistent places.
  • Warn your son before using a machine that makes loud noises (e.g., vacuum cleaner or blender).
  • Watch for distracting glares light fixtures may cast on windows and televisions.

There are infinite possibilities when it comes to constructing a more sensory-friendly environment in your home. Include your son in the planning, decision making, and creation process. His sensory needs could involve the reduction of stimuli -- or an increase of stimulation -- depending on the situation.

==> How to Prevent Meltdowns and Tantrums in Children with HFA and AS

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