Beyond Fire Drills and Shirt Tags
Autism and the other sensory sensitivities.
Posted July 8, 2019 | Reviewed by Devon Frye
Hearing. Sight. Smell. Taste. Touch.
These are what usually come to mind when we think of the senses—the five senses.
Notably, it was Aristotle who defined the senses in this way. He even gave them a name: "The 5 Outward Wits." The idea stuck and even today we often think of the senses as these 5 independently operating systems that arise from our interaction with the world outside of ourselves. However, a growing body of research demonstrates that the senses are much more varied and complicated than once thought.
Understanding the workings of our sensory system is crucial if we are to properly understand and support children on the autism spectrum. Difficulty with regulating sensory input is a common occurrence in autism. When the brain cannot effectively filter or organize sensory input, the sensations can break through in a manner that is experienced as harsh and overwhelming. This results in sensory sensitivities.
Why Address Sensory Sensitivities in Autistic Children?
Sensory sensitivities often result in anxiety for kids on the spectrum and it is our obligation to support children in finding relief. The distressing feelings that arise from sensitivities can also contribute to behavioral challenges (which are purely unintentional).
Sensory sensitivities can also lead to avoidance of situations, thereby limiting growth and independence. For example, it is often assumed that kids on the spectrum avoid social situations because they lack the desire to interact. However, in my clinical work, I often find that it is the sensory factors associated with social settings (e.g. noise, crowds), rather than lack of desire, that leads to avoidance of these situations.
My observations are supported by the research. Hochhauser and Engel-Yeger (2010), for example, found a correlation between atypical sensory processing abilities and participation in social, physical, and informal activities.
Moving Beyond the Traditional Model
The traditional model views each sensory channel as operating independently. However, senses often interact in complex and dynamic ways. Take the case of food aversions. A child on the spectrum may avoid a particular food for a combination of reasons, including the way it looks, the way it smells, the way it tastes, and its texture.
In addition, the traditional model only considers our interaction with the external environment. However, neuroscience now acknowledges that our senses also include the ways in which we experience our bodily, internal environment. This includes body positioning and internal states.
In regards to body positioning, our senses include:
- Vestibular Sense: Our sense of balance.
- Proprioception: The sense of positioning of our body parts in relation to each other.
- Kinesthesia: The sense of how our body is moving through space.
Sensory experiences related to our internal states are referred to as interoception. This includes all of the sensations we experience internally including (but not limited to): pain, temperature, hunger, thirst, barometric pressure, and the ability to sense an oncoming illness.
Interoception has drawn the attention of autism researchers and there is data indicating impaired processing in this area for autistic individuals (e.g. Fiene & Brownlow, 2015).
How Can We Tell if a Child is Being Impacted by Sensory Sensitivities?
- Ask. Children with developed communicative ability (through language or assistive devices) may be able to express which kinds of stimulation they find to be aversive. It is important to bear in mind that it may only be afterward, when the immediate distress is alleviated, that the child can reflect on the factor(s) that were causing problems.
- Infer. For children with less developed language ability, we may need to infer sensory sensitivities by observing signs of distress or behavioral changes. This often takes some detective work. Some sensory factors may be obvious (e.g. clear, immediate reaction to loud sound). Other factors, however, can be subtle or unexpected. Look for patterns and consistencies.
- Awareness. Be aware that there are many different sensory channels. In addition to the research base, I find it useful to read firsthand accounts from autistic persons through books, blogs, and social media postings. These help me to appreciate the many different sources of stimulation that may pose challenges for children on the spectrum.
What Can We Do?
- Prevent or minimize exposure to distressing stimuli. In some cases, you may be able to eliminate or adjust aversive sensations. Changes to the environment (e.g. using natural lighting, turning down noise, buying soft clothing) can be of enormous help.
- Help your child to anticipate challenging situations. Knowing that a potentially distressing event is coming up can help the child to prepare and will help prevent him or her from being caught off guard. Although this won't eliminate distress, it can help both a child and support persons to problem solve for getting through the situation.
- Work with a professional Occupational Therapist (OT). OTs can help to develop overall sensory regulation skills and a plan that can be used consistently across home and school settings.
- Sensory processing problems are prevalent in autism.
- Sensory sensitivities can result in high levels of distress, contribute to challenging behavior, and limit independence.
- Our sensory system extends beyond the traditional five senses and includes balance, movement, and internal sensations.
- Awareness and strategies can lessen the impact of sensory sensitivities.
Fiene, L., & Brownlow, C. (2015). Investigating interoception and body awareness in adults with and without autism spectrum disorder. Autism Research, 8 (6), 709-716.
Hochhauser, M., & Engel-Yeger, B. (2010). Sensory processing abilities and their relation to participation in lesiure activities among children with high-functioning autism spectrum disorder (HFASD). Research in Autism Spectrum Disorders, 4 (4). 746-754.