Sensory Diets for Kids on the Autism Spectrum

"What are your thoughts on 'sensory diets' for children with high functioning autism? Do they work? How do you implement them?"

Very few moms and dads have heard of a “sensory diet” for kids with Asperger’s (AS) and High-Functioning Autism (HFA).  Yet, a sensory diet may be the most important thing parents can do to help their children on the spectrum get through the “unstructured” summer months. In this article, we will look at what this diet is – and how you use it:

Just as your AS or HFA youngster needs food throughout the course of the day, his or her need for sensory input must also be met. A “sensory diet” is a carefully designed, personalized activity plan that provides the sensory input that a child on the autism spectrum needs to stay focused and organized throughout the day. Just as you may chew gum to stay awake or soak in a hot tub to unwind, AS and HFA kids need to engage in stabilizing, focused activities too. Infants, younger kids, teenagers – and even grown-ups with mild to severe sensory issues can all benefit from a personalized sensory diet.

Each AS and HFA youngster has a unique set of sensory needs. Generally, a youngster whose nervous system is on “high trigger/too wired” needs more calming input, while the youngster who is more “sluggish/too tired” needs more arousing input. Qualified occupational therapists can use their advanced training and evaluation skills to develop a good sensory diet for your youngster, but it’s up to you as a parent - and your youngster - to implement the diet throughout the course of the day.

Developing a sensory diet for your child is well worth the time and effort, because the effects of this diet are usually immediate AND cumulative. Activities that perk up your youngster or calm him/her down are not only effective in the moment – they actually help to restructure your youngster’s nervous system over time so that he or she is better able to (a) handle transitions with less stress, (b) limit sensory seeking and sensory avoiding behaviors, (c) regulate alertness, (d) increase attention span, and (e) tolerate sensations and situations that are challenging.

A sensory diet is like a diet that a nutritionist may recommend for proper nutrients and calories. It is developed to provide your AS or HFA youngster with the sensory stimulation (nutrients) that he or she requires for (a) helping maintain an optimum level of arousal, (b) promoting a level of alertness needed to develop self-regulation and behavioral organization, (c) increase gross/fine motor skills, (d) increase self-care and play/leisure skills, and (e) reducing sensory defensiveness.

The qualities of the sensory-motor activities recommended below impact the nervous system and have a modulating (i.e., calming or alerting) influence on behavior. Initially, the activities need to be repeated throughout the day (3 times works best) to help your youngster maintain an optimal level of behavior.  As behavior changes, it can be determined as to how much and how frequent sensory input is needed.

A sensory diet is made up of activities from several sensory systems, each having a different effect on the youngster’s nervous system. Below are descriptions of these sensory systems and their associated sensory-motor activities:

1. The Proprioceptive System: This system receives input from the joints and muscles and provides the child with information about the position of his or her body.  This input is strongest during movement and heavy work activities and helps with the integration of tactile input. Examples of activities which provide proprioceptive, deep pressure and heavy work input include the following:

• Arm wrestling
• Carrying heavy objects (e.g., filled laundry baskets, large soft drink bottles, a load of books, removing wet laundry from the washing machine, dragging or carrying grocery bags from the car to the kitchen) 
• Climbing on monkey bars, jungle gyms, or a chin-up bar
• Crashing into several large cushions, beanbags or comforters (e.g., have the youngster dive, jump, roll, stretch and burrow in the cushions; use a crash cushion by stuffing large foam scraps into a comforter cover or into a large bag made by sewing two sheets together)
• Have the child clean a mirror or window to help develop shoulder strength and stability
• Hide objects in play-doh or silly putty
• Make a sandwich out of the youngster between pillows, and add pressure as you pretend to put on pickles, cheese, lettuce, smooth on mayo, etc.
• Swimming
• Tug-of-war
• Wheelbarrow walking

Ways to get heavy work orally:

• Blowing bubbles
• Chewy foods (e.g., fruit leather, bagels, turkey jerky, gum, taffy, etc.)
• Crunchy foods (e.g., apple chunks, chips)

2. The Tactile System: This system is responsible for providing feedback about how something feels and where the child feels touch.  It allows the child to interpret if something is cold, hot, wet, dry, sharp or dull – and whether it is safe touch or unsafe touch. Examples of activities with tactile input (touch) include the following:

• Cut a hole in the top of a shoe box and place different objects in the box (e.g., a spool, marbles, plastic animals, little toys).  Hide items the child wants in this box (e.g., puzzle pieces or balls to a game) and have the child find the item he or she wants. 
• Fill a large washtub or kitchen sink with sudsy water and a variety of unbreakable pitchers, bottles, turkey basters, sponges, eggbeaters and toy pumps.  Pouring and measuring are excellent for developing the tactile system.
• Try finger painting on a tray or mirror with paints, sand mixed into paint, peanut butter, shaving cream or pudding.
• Offer different kinds of soap (e.g., oatmeal soap, shaving cream, lotion soap) and differently textured scrubbers (e.g., loofa sponges, thick washcloths, foam pot scrubbers, plastic brushes).

3. The Vestibular System: This system responds to motion, changes in head position and gravitational pull.  It is a very important system because of its influence over muscle tone, balance and equilibrium, posture, coordination of the two sides of the body, and the coordination or eye movements with head movements. Examples of activities with vestibular input (movement) include the following:

• Have the child swing on a swing set lying on his or her back, on the stomach, sitting, or standing.
• Have the child swing forward, backward, side to side, or rotating.
• Bouncing on a ball, or jumping on a trampoline or bed is a great activity.
• Throwing beanbags at a target while swinging is another effective activity.
• Use slides and merry-go-rounds.
• Wrapping the child in a blanket and unrolling him quickly (roll in both directions or down a hill) is yet another helpful activity.  
• Bouncing on a “hippity hop” ball is good too.

These sensory diets don’t have to take a long time.  Try to do them at the same time for 5-10 minutes throughout the day – especially during the unstructured summer months. It’s recommended that they are done at least 2-3 times a day, or immediately before the child is expected to do an activity requiring his or her undivided attention (e.g., doing homework). Also, be sure to ask your youngster’s occupational therapist for more ideas.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Obsessions and the Autistic Mind: Help for People on the Autism Spectrum

Lecture by Mark Hutten, M.A. - Part 1 discusses obsessive thinking among individuals with Asperger's and High-Functioning Autism:

More about intrusive thoughts in the autistic mind:

Obsessive thinking is like a CD in a CD-player that’s stuck and keeps repeating the same lyrics. It’s replaying an argument with a friend in your mind. It’s retracing past mistakes. When people obsess, they over-think or ruminate about situations or life events (e.g., school, work, relationships).

Research has shown that obsessive thinking is associated with a variety of negative consequences, including depression, anxiety, binge-drinking and binge-eating. For some people, drinking or binge-eating becomes a way to cope with life and drown out their obsessive thinking.

When people obsess while they are in depressed mood, they remember more negative things that happened to them in the past, they interpret situations in their current lives more negatively, and they are more hopeless about the future. Obsessive thinking also becomes the fast track to feeling helpless. Specifically, it paralyzes your problem-solving skills.

You become so preoccupied with the problem that you’re unable to push past the cycle of negative thoughts. It can even turn people away. When people obsess for an extended time, their family members and friends become frustrated and may pull away their support.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Creating an Effective “Social Skills” Training Program for Kids on the Spectrum

Impairment in social functioning is a core feature of Aspergers (AS) and High Functioning Autism (HFA). Typical social skill problems include the following: 

• taking another person’s perspective
• sharing enjoyment
• responding to the initiations of others
• reading the non-verbal cues of others
• maintaining eye contact
• initiating interactions

The cause of these social skill difficulties varies, ranging from neurological impairment to the lack of opportunity to acquire skills (e.g., social withdrawal). Most important, these skill problems make it difficult for the child to develop - and keep - fulfilling personal relationships. Although social skill problems are a core feature of AS and HFA, many of these kids do not receive adequate social skills training. This is a sad reality, especially considering that the presence of social deficits may lead to the development of more damaging outcomes (e.g., poor academic performance, social failure, peer rejection, anxiety, depression, etc.). The lack of proper social skills training is particularly troubling given the fact that most of the associated deficits can be corrected.

The long held notion that kids with AS and HFA lack an interest in social interactions is inaccurate. Most of these kids do indeed desire social involvement; however, they typically lack the necessary skills to interact effectively. This lack of “know-how” often leads to feelings of social anxiety. Many moms and dads report that social situations typically evoke a great deal of anxiety from their AS and HFA kids. 

Kids on the autism spectrum often describe an anxiety that resembles what many of us feel when we are forced to speak in public (e.g., increased heart rate, sweaty palms, noticeable shaking, difficulty concentrating, etc.). Not only is public speaking stressful, but just the thought of it is enough to produce a heightened state of anxiety. Now imagine living a life where every social interaction you experience was as stressful as having to make a speech in front of a big crowd. The typical coping strategy for most of us is to reduce the anxiety by avoiding the stressful situation.

For kids with AS and HFA, social anxiety often results in the avoidance of social situations, and subsequently, the development of social skill problems. When a youngster continually avoids social encounters, he denies himself the opportunity to acquire social skills. For many kids on the spectrum, these social skill difficulties lead to negative peer interactions, peer rejection, isolation, anxiety, depression, substance abuse – and even suicidal ideation. For others, it creates a pattern of engaging in solitary activities (a pattern that is often difficult to change).

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

So, what can parents do to help their AS and HFA children overcome social skills deficits?

The first step in social skills training should consist of conducting a thorough evaluation of the youngster’s current level of social functioning. The purpose of the assessment is to answer one very basic question: “What is preventing my youngster from establishing and maintaining social relationships?” For most kids, the answer takes the form of specific social skill problems. For others, the answer takes the form of cruel and rejecting peers. And for yet others, the answer is both. 

The evaluation should (1) detail both the strengths and weakness of the child related to social functioning, and (2) involve a combination of (a) observation (e.g., watching how your child interacts with others, (b) interviews (e.g., talking to your child, his teachers, his peers, etc.), and (c) standardized measures (e.g., behavioral checklists, social skills measures). 

Parents need to ascertain current level of functioning and effectively intervene at the youngster’s area of need. For example, if the evaluation reveals that your youngster is unable to maintain simple one-on-one interactions with peers, then the intervention should begin at this point, and not at a more advanced group interaction level. As another example, if the evaluation revels that your youngster does not know how to play symbolically - or even functionally - with play items, then the intervention will probably begin by teaching play skills prior to teaching specific interaction skills. 

After a thorough assessment of social functioning is complete, parents should then determine whether the skill problems identified are the result of “skill acquisition” issues or “performance” issues. A skill acquisition deficit refers to the absence of a particular skill or behavior (e.g., the youngster may not know how to effectively join-in games with peers, thus she will often fail to participate). A performance deficit refers to a skill or behavior that is present, but not demonstrated or performed (e.g., the youngster may have the ability to join-in an activity, but for some reason, fails to do so). 

In discerning between a skill acquisition deficit and a performance deficit, ask yourself the following question: “Can my youngster perform the task with multiple people and across multiple settings?” For example, if your youngster only initiates interactions with you at home, but not with peers at school, then you will need to address the initiation difficulty as a skill acquisition deficit.

Too often, social skill problems and inappropriate behaviors are incorrectly viewed as performance problems (i.e., parents assume that when their youngster does not perform a certain task, it is the result of refusal or lack of motivation). Parents need to understand that the majority of social skill problems in kids with AS and HFA can be attributed to skill acquisition problems (i.e., they are not performing socially because they lack the necessary skills to do so). If parents want their kids to be successful socially, then they will need to teach them the skills to be successful. 

The benefit of discerning between “skill acquisition” versus “performance” problems is that it guides the selection of intervention strategies. The intervention selected should match the type of deficit present. Once a thorough social skill assessment is completed, and the parent is able to attribute the social deficits to either skill acquisition or performance issues, social skills training can begin. 

When selecting intervention techniques, parents need to understand the concept of “accommodation” versus “assimilation.” Accommodation refers to the act of modifying the physical or social environment for the youngster in order to promote positive social interactions (e.g., training peer-mentors to interact with the youngster throughout the school day, autism awareness training for peers, having the child participate in various group activities like the Girl Scouts). While accommodation addresses changes in the child’s environment, assimilation focuses on changes in the child herself. Assimilation refers to training that facilitates skill acquisition that allows the youngster to be more successful in social interactions. 

The key to successful social skills training is to address both accommodation and assimilation. Focusing on one, but not the other, sets the youngster up for failure. In other words, providing social skills training (i.e., assimilation) without modifying the environment to be more accepting of the youngster (i.e., accommodation) is a recipe for a failed training program (e.g., when an eager youngster attempts a newly learned skill on a group of non-accepting peers).

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

There are number of important questions to consider when selecting appropriate social skill strategies. For example:

• What is the plan to evaluate the strategy’s effectiveness with the youngster?
• Is there research to support the use of this strategy? 
• Is the strategy developmentally appropriate for the youngster? 
• Does the strategy target the skill problems identified in the social assessment?
• Does the strategy promote skill acquisition?
• Does the strategy enhance performance?

Once parents have (a) assessed social skill functioning, (b) identified skills to teach, (c) discerned between skill acquisition and performance problems, and (d) selected intervention strategies, it is time to implement the strategies. Parents cannot do this alone however. Social skills training should be provided in multiple settings (e.g., home, classroom, resource room, playground, community, etc.) and by multiple providers (e.g., parents, teachers, coaches, therapists, etc.). 

There is no “best” place to teach social skills, though it is important to keep in mind that the purpose of all social skills training should be to promote social success “with peers in the natural environment.” For example, if the youngster is receiving social skills training from a private therapist, it is crucial that a plan be put in place to facilitate transfer of skills from the clinic to the child’s natural environment. Moms and dads and educators should look for opportunities to prompt and reinforce the skills that are being taught in the clinic. 

The rate of social skills acquisition will differ widely from one youngster to the next. Some kids will begin using their new skills after only 3 or 4 sessions, while other kids may require over 6 months before they begin to “get it.” In any event, simply trying a new skill is just the first step towards success. The youngster will need additional time to master the skill that he is learning and developing. 

“Assess and modify” is the last stage in the intervention process, but it is not the last thing to think about when designing a social skills training program. As soon as parents are able to identify the social skill problems to be addressed, they should begin to develop the methods for evaluating the effectiveness of the intervention. For example, if the target of the intervention is social initiations, then parents and teachers should take baseline data on the frequency of initiations with peers, and then continue to collect data on social initiations throughout the implementation stage of the intervention. 

Accurate data collection is important in evaluating the effectiveness of the intervention. It allows all parties involved to determine whether the youngster is benefiting from the training, and how to modify the training to best meet her needs. In school settings, accurate data collection is especially important. When parents work with school staff, the focus should be on integrating the social skills program with the youngster’s behavioral and social objectives. Also, the “assess and modify” stage is typically a very important part of IEP development and implementation.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism