Sensory Issues and Autism: An all you need to know guide for parents & caregivers

It’s Saturday morning, and the first thing on David’s to-do list for the weekend is to vacuum the house. As soon as the vacuum cleaner is turned on, his son Jack takes cover under blankets or hides under the dining table. He displays a similar behavior when the blender is run to prepare David’s favorite smoothie.

David’s colleague, Susan, has a different experience with her son Ethan, who is also autistic. Ethan showed no reaction when he took a fall in the garden. While his teachers went into panic, Ethan carried on as if nothing had happened. Susan had to guess, from Ethan’s limp, that he may have suffered a fracture.

Mundane happenings like the sound of the nail clipper or the tag in a new t-shirt rubbing against one’s skin may set off a meltdown in an autistic child due to the sensory issues associated with autism. In this blog, we will delve deeper into various aspects of sensory processing difficulties and their unique manifestations faced by children on the autism spectrum.

Sensory issues in ASD refer to difficulties in processing and responding to sensory stimuli, such as sights, sounds, textures, tastes, and smells. Autistic children are sometimes over-sensitive or under-sensitive to sensory information. This means their senses take in either too much or too little information from the environment around them. These sensory issues can significantly impact an autistic individual’s daily life, causing discomfort, anxiety, or challenges in regulating emotions and engaging in typical activities.

Sensory issues can happen to anyone, but are more typically seen in people on the ASD spectrum. Although up to 90% of people with spectrum disorders have sensory processing difficulties, Sensory Processing Disorder is a separate condition recognized in up to 16% of the general population.

The difference lies more in the way a neurotypical person processes multiple sensory inputs as compared to an autistic person.

Let’s meet two individuals, Alex and Sam, who will help us understand the difference between Autism Spectrum Disorder (ASD) and Sensory Processing Disorder (SPD).

Alex has been diagnosed with Autism Spectrum Disorder (ASD). He has challenges with social interactions and communication, and he also experiences sensory processing difficulties. For example, when Alex is in a busy shopping mall, he becomes overwhelmed by the noise from people talking, background music, and the echoing sounds in the large space. This sensory overload leads to Alex feeling anxious and distressed, and he covers his ears or tries to leave the mall to cope with the overwhelming sensory input.

On the other hand, Sam has Sensory Processing Disorder (SPD) but does not have Autism Spectrum Disorder. Sam is part of the general population, and he has difficulty processing sensory information without experiencing the social and communication challenges associated with ASD. For instance, when Sam goes to a restaurant, he finds it challenging to tolerate the texture of certain foods or feels extremely bothered by the flickering lights. As a result, Sam struggles to stay focused during the meal and avoids certain types of restaurants or food items that trigger his sensory difficulties.

In summary, both Alex and Sam experience sensory processing difficulties, but Alex’s difficulties are part of his autism spectrum disorder, while Sam’s sensory processing issues are recognized as Sensory Processing Disorder as a separate condition within the general population. It is essential to recognize and address these sensory difficulties in individuals to support their well-being and daily functioning.

The sensory system serves as a gateway through which we perceive and interpret the world around us. It encompasses various senses, such as sight, hearing, touch, taste, and smell, allowing us to gather information from the environment and interact with it effectively.

Sensory integration is how our brain processes and understands the things we feel, hear, see, and touch. When it works well, we can make sense of the world around us. For neurotypical people, sensory integration happens naturally and helps them make sense of their surroundings. Their brain effectively combines and understands information from their senses like touch, sight, sound, and more. This allows them to navigate the world comfortably and process information without much difficulty.

For some people, especially those on the autism spectrum, sensory integration may not be functioning optimally. They may experience challenges in effectively integrating sensory inputs. This can lead to difficulties in processing sensory input, which may affect their development, how they process information, and their behavior. For example, certain sounds or textures might be overwhelming or uncomfortable for them, making it harder for them to concentrate or engage in certain activities. As a way to deal with the discomfort arising out of poor sensory integration, autistic individuals may resort to one of several behavioral patterns such as stimming, rocking, anxiety, hand flapping, etc, when they are put through difficult emotions or multiple sensory inputs.

• Hypersensitivity, also known as over-sensitivity
• Hyposensitivity, also known as under-sensitivity

These terms describe how children with autism perceive and process sensory information from their environment.

• Hypersensitivity refers to an increased sensitivity to sensory stimuli.
• People with hypersensitivity may experience an exaggerated response to certain sensory inputs, such as sound, light, touch, taste, or smell.
• For example, they may find certain sounds or textures extremely overwhelming or painful. Everyday sensory experiences that most people find tolerable or even unnoticeable can be distressing or uncomfortable for individuals with hypersensitivity.

• Hyposensitivity, on the other hand, refers to a decreased sensitivity to sensory stimuli.
• People with hyposensitivity may have a diminished response to sensory inputs and may seek more intense or stimulating sensations to feel satisfied.
• They may engage in behaviors like seeking out strong smells, loud noises, or repetitive movements to compensate for the reduced sensory input. For instance, they might enjoy spinning, jumping, or seeking deep pressure to stimulate their senses.

It is important to note that sensory issues in autism can vary greatly from person to person. Some children may experience a combination of hypersensitivity and hyposensitivity in different sensory domains, while others may have more pronounced issues in one area and fewer in others.

Sensory integration is all about how our body processes and understands three important senses:

• Touch
• Balance
• Body awareness

These senses start developing even before we are born and continue to grow as we grow older and interact with the world around us. They are not as well-known as our ability to see and hear, but they are extremely important for our survival. Understanding these different senses and how they work together can help us support and empathize with individuals who may experience sensory sensitivities or differences.

Understanding the two ends of the sensitivity spectrum is crucial to providing appropriate support and creating sensory-friendly environments for autistic children. Here are some common expressions of hyper and under sensitivity.

Sensory issues can occur at any age in individuals with autism. They can be present from early childhood and persist into adulthood. However, sensory issues may manifest differently and vary in intensity from person to person.

In some cases, sensory issues may be evident even before a formal autism diagnosis is made. Parents and caregivers may observe atypical reactions to sensory stimuli, such as a strong aversion to certain sounds or textures, or seeking out intense sensory experiences. These early signs can provide valuable insights into an individual’s sensory processing challenges.

It is important to note that sensory issues can be fluid and change over time. As an individual progresses through different stages of life, their sensory challenges are subject to dynamic changes, potentially giving way to new issues or even showing signs of improvement. Additionally, the intensity of sensory issues can vary from day to day or in different environments, depending on factors such as stress levels, fatigue, and sensory demands.

For effective management of sensory issues, autistic children need help from specialists like occupational therapists to develop coping techniques. Occupational Therapists (OT) can help identify how a child processes and responds to sensory stimuli. They establish areas of difficulty, and teach the kids effective strategies, techniques to cope with the sensory issues. The therapy is done in a play-based environment and structured in a way to slowly integrate the kids and help them overcome the sensory challenges. Therapists provide valuable guidance to parents or care-givers on how to effectively handle kids during sensory meltdowns. They also provide tips and tools to effectively identify, mitigate, and avoid sensory stimuli.

Occupational therapy is conducted either through the school or through the parents. Occupational therapy, on occasion, receives coverage from insurance providers. Moreover, Early Intervention Services offer this service to eligible children as well.

The strategies and techniques that help in dealing with sensory issues can be broadly grouped in three categories as listed below:

Withdrawal: Some autistic children may withdraw or retreat from overwhelming sensory stimuli. For instance, they might move to a quieter area or cover their ears to reduce auditory input.

Avoiding Certain Stimuli: They may actively avoid situations or environments that trigger sensory discomfort. This could involve staying away from crowded places, bright lights, or strong smells.

Stimulatory Behaviors: Autistic children might engage in self-stimulatory behaviors, also known as “stimming,” to self-regulate and find comfort. This can include actions like hand-flapping, rocking, or repetitive movements.

Deep Pressure or Compression: Applying deep pressure or seeking compression through weighted blankets, hugs, or tight clothing can help provide a calming effect and regulate their sensory system.

Creating Personal Retreat Spaces: Autistic children like their own personal retreat spaces where they can go to find comfort and regulate their sensory system. This could be a designated corner with cozy cushions, soft lighting, and favorite sensory items like fidget toys or weighted blankets.

Sensory Breaks: Autistic children may take sensory breaks when they feel overwhelmed. These breaks involve temporarily removing themselves from the overwhelming environment to a quieter, calmer space where they can relax and self-regulate. Autism classrooms have tents/spaces for privacy where kids are encouraged to spend quiet time when kids are feeling overwhelmed.

Personalized Sensory Kits: Occupational therapists create and provide personalized sensory kits containing items that help autistic children cope with specific sensory challenges. These kits could include earplugs, sunglasses, scented items, or tactile objects that provide comfort or reduce sensory input.

These techniques empower autistic children who are unable to handle the discomfort of sensory issues to adapt to their environment according to their sensory needs, allowing them to regulate their experiences and find relief from overwhelming sensory stimuli.

However, some autistic children who have developed communication skills may use verbal or non-verbal means to express their sensory needs and preferences. For example, they may say, “I don’t like tags on my shirt, can I have one without?” This helps caregivers and teachers understand and support them. Through communication, they seek understanding and accommodations for their sensory experiences.

If someone is having a meltdown, or not responding, don’t judge them. This is a four-step process you can follow to manage it:

Be aware: Recognize the signs of sensory overload in an autistic person, such as covering their ears, displaying distress, or exhibiting repetitive behaviors. Understand that meltdowns are a natural response to overwhelming sensory stimuli and should not be judged.

Be creative: Explore sensory-friendly strategies to help manage the overload. This could include creating a calm and quiet environment, providing noise-canceling headphones or earplugs, dimming lights, or offering sensory tools like fidget toys or weighted blankets. Be open to individual preferences and adapt the environment to suit their needs. The special sensory needs of autistic children are being recognized in many spheres of society. Premier scientific institutions such as the Kennedy Space Centre have become a Certified Autism Center. As part of the certification, the visitor complex will designate areas where people with sensory sensitivities can relax in less stimulating surroundings, providing a break from potential sensory overload

Be prepared: Educate yourself about the specific sensory triggers that can lead to meltdowns for the person you’re supporting. Talk to them or their caregivers to gather information about their sensitivities and coping mechanisms. This preparation allows you to anticipate potential triggers and have appropriate resources readily available to help them through a meltdown.

Respond well: During a meltdown, respond with patience and understanding. Avoid making demands or trying to stop the meltdown forcefully. Instead, provide a calm presence and give them space if needed. If the person is nonverbal or has difficulty communicating, use visual cues or simple language to convey reassurance. Offer support without judgment, allowing them to express their emotions and providing comfort until the sensory overload subsides.

Remember, each autistic individual is unique, and what works for one person may not work for another. It is essential to be flexible, patient, and responsive to the individual’s needs and preferences when managing sensory issues in autism.

Understanding the implications of sensory issues in autism is crucial to providing appropriate support and accommodations. Providing opportunities for sensory regulation, offering sensory breaks, and using adaptive strategies can help minimize the impact of sensory issues and promote a more inclusive and comfortable experience for individuals with autism. Together, we can create a world where sensory sensitivities are acknowledged, respected, and supported.

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  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086654/
• Sensory features in autism: Findings from a large population-based surveillance system
  https://pubmed.ncbi.nlm.nih.gov/35040592/
• Sensory Abnormalities in Autism Spectrum Disorders: A Focus on the Tactile Domain, From Genetic Mouse Models to the Clinic
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• An In-Depth Look at Sensory Integration
  https://autism.org/sensory-integration/
• Study Finds Sensory Integration Therapy Benefits Children with Autism
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• The Impact of the Presence of Intellectual Disabilities on Sensory Processing and Behavioral Outcomes Among Individuals with Autism Spectrum Disorders: a Systematic Review
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• The National Autistic Society:
  https://www.autism.org.uk/advice-and-guidance/topics/sensory-world
• Autism Speaks:
  https://www.autismspeaks.org/sensory-issues
• Sensory Processing Disorder Foundation:
  https://www.spdfoundation.net/about-sensory-processing-disorder
• Research Autism:
  http://www.researchautism.net/about-autism/sensory-issues
• Autism Research Institute (ARI):
  https://www.autism.com/symptoms_sensory_overview
• Interactive Autism Network (IAN):
  https://iancommunity.org/sensory-issues-autism
• Autism Research Centre (ARC):
  https://www.autismresearchcentre.com/understanding-autism/sensory-symptoms
• Autism Society:
  https://www.autism-society.org/sensory-processing/
• Child Mind Institute:
  https://childmind.org/topics/concerns/sensory-processing-issues/
• Sensory Integration Network:
  https://www.sensoryintegration.org.uk/
• The STAR Institute for Sensory Processing Disorder:
  https://www.spdstar.org/
• Autism Research Review International:
  https://www.autism.com/ari/review/intro
• https://www.autism.org.uk/advice-and-guidance/topics/sensory-differences/sensory-differences/all-audiences