Many people on the autism spectrum have difficulty processing everyday sensory information. Any of the senses may be over- or under-sensitive, or both, at different times. These sensory differences can affect behavior, and can have a profound effect on a person’s life. Here we help you to understand autism, the person and how to help. You can also find out about synaesthesia, therapies and equipment.
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Sometimes an autistic person may behave in a way that you wouldn’t immediately link to sensory sensitivities. A person who struggles to deal with everyday sensory information can experience sensory overload, or information overload. Too much information can cause stress, anxiety, and possibly physical pain. This can result in withdrawal, challenging behavior or meltdown.
If I get sensory overload then I just shut down; you get what’s known as fragmentation…it’s weird, like being tuned into 40 TV channels.
If someone is having a meltdown, or not responding, don’t judge them. There are things that you can do to help. This can make a world of difference to someone with autism and their carers.Often, small changes to the environment can make a difference. Creating a sensory profile may help you to work out what changes are needed. Three points to remember are:
* be aware. Look at the environment to see if it is creating difficulties. Can you change anything?
* be creative. Think of some positive sensory experiences.
* be prepared. Tell the person about possible sensory stimuli they may experience in different environments.
Here we look at some of the effects of hypersensitivity or hyposensitivity to sights, sounds, smells, tastes, touch, balance and body awareness, and ways you could help.
* Objects appear quite dark, or lose some of their features.
* Central vision is blurred but peripheral vision quite sharp.
* A central object is magnified but things on the periphery are blurred.
* Poor depth perception, problems with throwing and catching, clumsiness.
Ways you might help include the use of visual supports or colored lenses, although there is only very limited research evidence for such lenses.
* Distorted vision – objects and bright lights can appear to jump around.
* Images may fragment.
* Easier and more pleasurable to focus on a detail rather than the whole object.
* Has difficulty getting to sleep as sensitive to the light.
She was Mrs Marek, a face upon which light danced maniacally, turning her into more of a cartoon than a human being. Welcome to Toon town…I’d like you to enter this torture chamber I call my kitchen and meet my wife who is a 3D cartoon. Gillingham, G. (1995), page 51
You could make changes to the environment such reducing fluorescent lighting, providing sunglasses, using blackout curtains, creating a workstation in the classroom – a space or desk with high walls or divides on both sides to block out visual distractions, using blackout curtains.
* May only hear sounds in one ear, the other ear having only partial hearing or none at all.
* May not acknowledge particular sounds.
* Might enjoy crowded, noisy places or bang doors and objects.
You could help by using visual supports to back up verbal information, and ensuring that other people are aware of the under-sensitivity so that they can communicate effectively. You could ensure that the experiences they enjoy are included in their daily timetable, to ensure this sensory need is met.
* Noise can be magnified and sounds become distorted and muddled.
* May be able to hear conversations in the distance.
* Inability to cut out sounds – notably background noise, leading to difficulties concentrating.
Do you hear noise in your head? It pounds and screeches. Like a train rumbling through your ears. Powell, J., in Gillingham, G. (1995), page 41
You could help by:
* shutting doors and windows to reduce external sounds
* preparing the person before going to noisy or crowded places
* providing ear plugs and music to listen to
* creating a screened workstation in the classroom or office, positioning the person away from doors and windows.
* Some people have no sense of smell and fail to notice extreme odors (this can include their own body odor).
* Some people may lick things to get a better sense of what they are.
You could help by creating a routine around regular washing and using strong-smelling products to distract people from inappropriate strong-smelling stimuli (like faces).
* Smells can be intense and overpowering. This can cause toileting problems.
* Dislikes people with distinctive perfumes, shampoos, etc.
Smells like dogs, cats, deodorant and aftershave lotion are so strong to me I can’t stand it, and perfume drives me nuts. Gillingham, G. (1995), page 60
You could help by using unscented detergents or shampoos, avoiding wearing perfume, and making the environment as fragrance-free as possible.
* Likes very spicy foods.
* Eats or mouths non-edible items such as stones, dirt, soil, grass, metal, faces. This is known as pica.
* Finds some flavors and foods too strong and overpowering because of very sensitive taste buds. Has a restricted diet.
* Certain textures cause discomfort – may only eat smooth foods like mashed potatoes or ice-cream.
Some autistic people may limit themselves to bland foods or crave very strong-tasting food. As long as someone has some dietary variety, this isn’t necessarily a problem. Find out more about over-eating and restricted diets.
* Holds others tightly – needs to do so before there is a sensation of having applied any pressure.
* Has a high pain threshold.
* May be unable to feel food in the mouth.
* May self-harm.
* Enjoys heavy objects (eg weighted blankets) on top of them.
* Smears faces as enjoys the texture.
* Chews on everything, including clothing and inedible objects.
You could help by:
* using weighted blankets or sleeping bags
* for smearing, offering alternatives to handle with similar textures, such as jelly, or cornflour and water
* for chewing, offering latex-free tubes, straws or hard sweets (chill in the fridge).
* Touch can be painful and uncomfortable – people may not like to be touched and this can affect their relationships with others.
* Dislikes having anything on hands or feet.
* Difficulties brushing and washing hair because head is sensitive.
* May find many food textures uncomfortable.
* Only tolerates certain types of clothing or textures.
Every time I am touched it hurts; it feels like fire running through my body. Gillingham, G. (1995), page 3
You could help by:
* warning the person if you are about to touch them – always approach them from the front
* remembering that a hug may be painful rather than comforting
* changing the texture of food (that is, purée it)
* slowly introducing different textures around the person’s mouth, such as a flannel, a toothbrush and some different foods
* gradually introducing different textures to touch, that is, have a box of materials available
* allowing a person to complete activities themselves (that is, hair brushing and washing) so that they can do what is comfortable for them
* turning clothes inside out so there is no seam, removing any tags or labels
* allowing the person to wear clothes they’re comfortable in.
* A need to rock, swing or spin to get some sensory input.
You could encourage activities that help to develop the vestibular system. This could include using rocking horses, swings, roundabouts, seesaws, catching a ball or practicing walking smoothly up steps or curbs.
* Difficulties with activities like sport, where we need to control our movements.
* Difficulties stopping quickly or during an activity.
* Car sickness.
* Difficulties with activities where the head is not upright or feet are off the ground.
You could help by breaking down activities into small, more easily manageable steps and using visual cues such as a finish line.
Body awareness (proprioception)
Our body awareness system tells us where our bodies are in space, and how different body parts are moving.
* Stands too close to others, because they cannot measure their proximity to other people and judge personal space.
* Finds it hard to navigate rooms and avoid obstructions.
* May bump into people.
You could help by:
* positioning furniture around the edge of a room to make navigation easier
* putting colored tape on the floor to indicate boundaries
* using the ‘arm’s-length rule’ to judge personal space – this means standing an arm’s length away from other people.
* Difficulties with fine motor skills, that is, manipulating small objects like buttons or shoe laces.
* Moves whole body to look at something.
You could help by offering ‘fine motor’ activities like lacing boards.
Synaesthesia is a rare condition experienced by some people on the autism spectrum. An experience goes in through one sensory system and out through another. So a person might hear a sound but experience it as a color. In other words, they will ‘hear’ the color blue.
Therapies and equipment
We can’t make recommendations as to the effectiveness of individual therapies and interventions or equipment. Research Autism provides free information about autism therapies and interventions.
* Music therapists use instruments and sounds to develop people’s sensory systems, usually their auditory (hearing) systems.
* Occupational therapists design programs and often make changes to the environment so that people with sensory difficulties can live as independently as possible.
* Speech and language therapists often use sensory stimuli to encourage and support the development of language and interaction.
* Some people say they find colored filters helpful, although there is only very limited research evidence.
Laurie, C. (2014) Sensory Strategies London: The National Autistic Society
Higashida, Naoki (2014) The Reason I Jump: One boy’s voice from the silence of autism. Sceptre
Grandin, T. (2006) Thinking in Pictures. Bloomsbury Publishing