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Making Sense of Sensory Sensitivities in Kids on the Autism Spectrum

Many children with Aspergers and High-Functioning Autism (HFA) have difficulty processing everyday sensory information (e.g., sounds, sights, smells). This is called “sensory sensitivity,” and it can have a profound effect on a child’s life.

Most “neurotypical” children (i.e., kids without the disorder) process sensory information automatically without needing to think about it much. However, children with sensory sensitivities have difficulty processing everyday sensory information. Those who struggle to deal with all this information are likely to become stressed or anxious, and possibly feel physical pain. This can result in difficult behavior. If the Aspergers or HFA child gets sensory overload, he may just “shut down.” He experiences what is known as “fragmentation” (similar to being tuned into 20 TV channels at once).



Children with ASD can be over-sensitive (i.e., hypersensitive) or under-sensitive (i.e., hyposensitive) in any of the following seven areas:

1. Sight—

Situated in the retina of the eye and activated by light, our sight helps us to define objects, people, colors, contrast and spatial boundaries. Children on the autism spectrum may experience the following differences:

Hyposensitive:

•    A central object is magnified, but things on the periphery are blurred.
•    Central vision is blurred, but peripheral vision quite sharp.
•    Objects appear quite dark or lose some of their features.
•    Poor depth perception – problems with throwing and catching; clumsiness.

Hypersensitive:

•    Distorted vision: objects and bright lights can appear to jump around.
•    Easier and more pleasurable to focus on a detail rather than the whole object.
•    Images may fragment.

2. Sound—

This is the most commonly recognized form of sensory impairment. Hearing impairments can affect a person’s ability to communicate as well as his balance. Children with Aspergers and HFA may experience the following differences:

Hyposensitive:

•    May not acknowledge particular sounds.
•    May only hear sounds in one ear, the other ear having only partial hearing or none at all.
•    Might enjoy crowded, noisy places or bang doors and objects.

Hypersensitive:

•    Inability to cut out sounds – notably background noise, which often leads to difficulties concentrating.
•    Noise can be magnified and sounds become distorted and muddled.
•    Particularly sensitive to sound and can, for example, hear conversations in the distance.

3. Touch—

Touch is important for social development. It helps us to assess the environment we are in and react accordingly. It also allows us to feel pain. Children on the spectrum may experience the following differences:

Hyposensitive:

•    Enjoys heavy objects (e.g., weighted blankets) on top of them.
•    Has a high pain threshold.
•    Holds others tightly - needs to do so before there is a sensation of having applied any pressure.
•    May self-harm.

Hypersensitive:

•    Difficulties brushing and washing hair because head is sensitive.
•    Dislikes having anything on hands or feet.
•    Only likes certain types of clothing or textures.
•    Touch can be painful and uncomfortable; child may not like to be touched, and this can affect his relationships with others.

4. Taste—

Chemical receptors in the tongue tell us about different tastes (e.g., sweet, sour, spicy, etc.). Children with Aspergers and HFA may experience the following differences:

Hyposensitive:

•    Eats everything (e.g., soil, grass, Play-dough, etc.). This is called “pica.”
•    Likes very spicy foods.

Hypersensitive:

•    Certain textures cause discomfort; some children will only eat smooth foods (e.g., mashed potatoes, ice-cream).
•    Finds some flavors and foods too strong and overpowering because of very sensitive taste buds; has a restricted diet.

5. Smell—

Chemical receptors in the nose tell us about smells in our immediate environment. Smell is the first sense we rely upon. These young people may experience the following differences:

Hyposensitive:

•    Some kids may lick things to get a better sense of what they are.
•    Some kids have no sense of smell and fail to notice extreme odors (can include their own body odor).

Hypersensitive:

•    Dislikes people with distinctive perfumes, shampoos, etc.
•    Smells can be intense and overpowering. This can cause toileting problems.

6. Balance (vestibular)—

Situated in the inner ear, our vestibular system helps us maintain our balance and posture, and understand where and how fast our bodies are moving. Children with Aspergers and HFA may experience the following differences:

Hyposensitive:

•    A need to rock, swing or spin to get some sensory input.

Hypersensitive:

•    Car sickness.
•    Difficulties stopping quickly or during an activity.
•    Difficulties with activities like sport, where the child needs to control his movements.
•    Difficulties with activities where the head is not upright or feet are off the ground.

7. Body awareness (proprioception)—

Situated in the muscles and joints, our body awareness system tells us where our bodies are in space, and how different body parts are moving. Children with Aspergers and HFA may experience the following differences:

Hyposensitive:

•    Hard to navigate rooms and avoid obstructions.
•    May bump into people.
•    Stands too close to others, because they cannot measure their proximity to other people and judge personal space.

Hypersensitive:

•    Moves whole body to look at something.
•    Difficulties with fine motor skills: manipulating small objects (e.g., buttons, shoe laces).

Note: “Synaesthesia” is a rare condition which some Aspergers and HFA kids experience. A sensory experience goes in through one system and out through another. So the child might hear a sound -- but experience it as a color (i.e., they will 'hear' the color blue).



*** How Parents and Teachers Can Help ***

Here are some ways you may be able to help a child with Aspergers or High-Functioning Autism with sensory sensitivities:

Sight—

Hyposensitive:

•    Increase the use of visual supports.

Hypersensitive:

•    Create a workstation in the classroom (i.e., a space or desk with high walls or divides on both sides to block out visual distractions).
•    Reduce fluorescent lighting. Use deep-colored light bulbs instead.
•    Use blackout curtains.
•    Wear sunglasses.

Sound—

Hyposensitive:

•    Use visual supports to back up verbal information.

Hypersensitive:

•    Create a workstation.
•    Listen to music.
•    Prepare the child before going to noisy or crowded places.
•    Shut doors and windows to reduce external sounds.
•    Wear ear plugs.

Touch—

Hyposensitive:

•    Use weighted blankets or sleeping bags.

Hypersensitive:

•    Allow the child to complete activities themselves (e.g., hair brushing and washing) so that they can do what is comfortable for them.
•    Gradually introduce different textures. Have a box of materials available.
•    Remember that a hug may be painful rather than comforting.
•    Warn the child if you are about to touch him; always approach him from the front.

Taste—

Some kids on the spectrum are hyper- or hyposensitive to taste, and may limit themselves to bland foods or crave very strong-tasting food. As long as the child eats a bit of a varied diet, taste sensitivity isn't necessarily a problem.

Smell—

Hyposensitive:

•    Use strong-smelling products as rewards and to distract the child from inappropriate strong-smelling stimuli (e.g., feces).

Hypersensitive:

•    Use unscented detergents or shampoos, avoid wearing perfume, and make the environment as fragrance-free as possible.

Balance—

Hyposensitive:

•    Encourage activities that help to develop the vestibular system. This can include using rocking horses, swings, roundabouts, seesaws, and games like catching a ball or practice walking smoothly up steps or curbs.

Hypersensitive:

•    Break down activities into small, more easily manageable steps; use visual cues (e.g., a finish line).

Body awareness—

Hyposensitive:

•    Use the “arm's-length” rule to judge personal space. This means standing an arm's length away from other people.
•    Put colored tape on the floor to indicate boundaries.
•    Position furniture around the edge of a room to make navigation easier.

Hypersensitive:

•    Do “fine motor” activities (e.g., lacing boards).


*** How Sensory Sensitivities Affect Behavior ***

Sometimes, children with Aspergers and HFA may behave in a way that you wouldn't immediately link to sensory sensitivities – but they may be the underlying cause. Here are some examples of how a child’s behavior may result from sensory sensitivities, and how parents can help:

Picky eater:

•    Possible reasons: sensitive to taste or texture, or unable to feel food around the mouth.
•    Possible solutions: change the texture of food (e.g., purée it). Slowly introduce different textures around the child’s mouth (e.g., a toothbrush, some different foods). Encourage activities that involve the mouth (e.g., whistles, bubble wands).

Chews on everything (e.g., clothing, objects):

•    Possible reasons: may find this relaxing, or enjoy the sensation of chewing on the item.
•    Possible solutions: offer latex-free tubes, straws or hard sweets.

Smearing:

•    Possible reasons: may like the texture of feces or not be very sensitive to smells.
•    Possible solutions: try and introduce things (e.g., jelly, corn flour, water) to handle instead; introduce alternative strong-smelling items.

Refuses to wear certain clothes:

•    Possible reasons: may dislike the texture or pressure of clothes on his skin.
•    Possible solutions: turn clothes inside out so there is no seam, remove any tags or labels, allow the child to wear clothes he’s comfortable in.

Difficulties getting to sleep:

•    Possible reasons: may have difficulty shutting down his senses, in particular sight and hearing.
•    Possible solutions: use blackout curtains or weighted blankets; listen to music to cut out external sounds.

Finds it difficult to concentrate in the classroom:

•    Possible reasons: too many distractions (e.g., noise, talking, bells, chairs scraping the floor, etc.) or visual stimuli (e.g., people, pictures on the wall, etc.). May also find holding a pencil uncomfortable (it may feel hard or cold).
•    Possible solutions: position the student away from doors and windows so there are fewer distractions. If possible, use an individual workstation with some screens around it or use classroom furniture to create a distraction-free area for the student. Try different textures to make the pencil more comfortable.



*** How Professionals Can Help ***

1.    Music therapists use instruments and sounds to develop the child’s sensory systems, usually their auditory (hearing) systems.

2.    Occupational therapists design programs and often make changes to the environment so that adults with sensory difficulties can live as independently as possible.

3.    Speech and language therapists often use sensory stimuli to encourage and support the development of language and interaction.

4.    Sensory rooms can help to stimulate, develop or balance the child’s sensory systems. Some specialist schools, local services and hospitals have them, as well as some nurseries. You may also come across sensory gardens. Some families create a sensory room in their house (or adapt a corner of a room, perhaps screening it off with a curtain).

Sensory rooms might include:
  • bubble tubes
  • disco lights 
  • equipment that is activated by switches, movement, sound or pressure so that children learn about cause and effect
  • fiber optics 
  • mirror balls 
  • projectors 
  • soothing music 
  • tactile walls 
  • vibrating cushions 
  • water beds

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15 comments:

Anonymous said...

Love this article! Thanks so much!

Anonymous said...

Thanks again for posting another informative article! I appreciate all you do.

Anonymous said...

My son was super sensitive to light and sound, sunglasses and CD player with soft white noise worked wonders!

Anonymous said...

This should be required reading for parents AND teachers.

Melanie said...

Thank you for this article! I am going to print out a copy for my daughter's teachers.

Anonymous said...

My daughter is 9 and still screams and crys if I have to brush her hair. I usually allow her to do it, because she does it gently enough for her head, but every now and then I have to get in there and get knots out. It breaks my heart to see her suffer because I am brushing her hair.

Anonymous said...

It breaks my heart when I have to brush my 9 year olds hair. She usually does it herself, so she can be as gentle as she needs. Occationally, however I have to brush to get out all the knots.

Anonymous said...

New to this site. Really great article. Thanks!

Anonymous said...

New to this site. Great article. Thanks!

Anonymous said...

Hello Dr. Hutten,

I just wanted to say thank you for your wonderful post. You always have the best way at describing things related to Autism in easy terms. I have two girls on the spectrum and also run a parent support group in my area. I have my Deaf Ed degree and my Autism Certificate. Just wanted to tell you thanks and I often share your posts with my families and schools.

Thanks, Jennifer

Anonymous said...

I sometimes wish that people who are judgemental knowing nothing about what it really is would have to live a whole day with what people with autism and sensory issues have to deal with all the time. Then maybe they wouldn't be so quick to say the wrong things.

Emily said...

I suspect I have Aspergers but have not had a fromal diagnosis or referral. I am hypersensitive to smell and taste. I was wondering, is not liking rain to do with sensory difficulties? For me, it is loud and it looks horrid and I hate the feeling of it on my skin...

Randy Floor said...

Special children do really need care and lots of attention. They are fighting against the world of criticize. As parents, you are obliged to give them what they need.

Anonymous said...

I adopted my son through foster care. We received him right from the hospital after birth. He is now 9 years old. He had been diagnosed with Asperger's, ADHD, Mood and Anxiety Disorder. His Aspergers' diagnosis was given almost a year ago. Through his therapies, and research of my own, it has been discovered that I too have Asperger's. I've tried to find information on an Asperger's parent parenting an Asperger's child, but can't find any. I have been pleading for help from all kinds of services in my area. My son does go to the CADD Center in Lancaster, PA (Center of Autism) and we live in Lebanon, PA. We are to be finally getting a BSC (Behavioural Specialist) to come to the home 6 hours a month. We've had many TSS's and MT's already try to help, but didn't really get anywhere. He had services since he was 4 years old. He is taking Abilify 5mg and Tenex 1 mg (1/2 am & 1/2 at 4:00 p.m.). He can not take stimulants due to them exacerbating his blow ups. He gets VERY anger VERY quick and has high anxiety. He is obsessed with toys and seems to have an addiction to wanting something new all the time. Do you have any suggestions that could help?

Unknown said...

Don't forget Interoception - the awareness of things going on in the body like full stomach, bowel or bladder.
Also please emphasise that sensory sensitivities occur in Neurotypical people and not just ASD. I have 2 kids, one HFASD and one NT and both have sensory sensitivities, in different areas.
But a very good article nevertheless. Thanks!

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