Autism spectrum disorder is often associated with sensory challenges. Although the DSM-V criteria for the diagnosis of autism spectrum disorder does not specifically state that people with autism always experience sensory challenges, this credible diagnostic manual does point out that sensory challenges can be a trait of ASD.
Traits of Autism May Include Sensory Challenges
People with autism experience social and communication challenges as well as what is known as restricted or repetitive behaviors. These behaviors look different from one person to another, but the behaviors that a person with autism displays generally include at least two of the following (DSM-5):
- Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, a need to take the same route or eat the same food every day).
- Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
- Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
So, as you can see in the last item mentioned, people with autism can by hyperreactive or hyporeactive to sensory input or they can have unusual interests in sensory stimuli around them.
Sensory Experiences : Hyperreactivity and Hyporeactivity
Being HYPERreactive to sensory input means that the person is more sensitive to what they experience through their senses.
For instance, someone who is hyperreactive to the sounds they hear when in a group of people is likely to be more overwhelmed and stressed by this experience as compared to most other people. Most other people might not notice the chatter of people talking over each other or the noises made by people moving around or the chewing sounds of people eating, but people who are hyperreactive to sensory input might be more likely to notice these things. They might notice these things more intensely, as well, which may be a very unpleasant experience for them especially if they are not fond of the noises they are hearing.
On the other hand, someone who is HYPOreactive to sensory input is likely to experience less sensitivity to things they experience through their senses. For instance, someone who is hyporeactive is under-responsive to sensory input. They may not register or attend to certain stimuli in their environment. In a group of people, they might not notice another person has started talking and they might unintentionally talk over other people in a loud voice.
Focus on the Best Interest of the Person
It’s important to remember that just because someone may be hyperreactive or hyporeactive to sensory input as compared to others, it doesn’t necessarily mean that this tendency should be changed just so they become more like most other people. The way a person experiences sensory input may or may not be appropriate as something to be “worked on.” It depends on many factors but primarily what is best for that individual as well as what the person (and their caregiver) would like to work toward to help that individual live the life they want to live.
So, when considering whether to help your child or a client with their sensory experiences, keep in mind what it is that is in their best interest for their current and future life and well-being.
Sensory Challenges for People with Autism
As we mentioned, not all individuals with ASD will have sensory challenges, but many of them will. Most people with ASD will experience differences in the way they experience sensory input at least from time to time while some people with ASD will have extreme difficulty with certain sensory experiences. It’s important to remember that we all have sensory issues. We all respond to sensory input from our environment in different ways. For instance, you might enjoy the feeling of soft blankets whereas another person might find that same texture very unnerving. You might find a warm cup of coffee energizing while someone else feels more energized from a cold cup of coffee (and this difference is due to the temperature of the drink despite the caffeine content being the same in both). So, as you can see, everyone has different sensory needs and ways of handling sensory input.
Change the Person or Change Their Environment?
For people with autism, sensory experiences can bring many challenges. Sometimes, though, they just view and experience things differently and that’s not a bad thing, so it’s important to know when sensory experiences should be addressed and when the person could work on making their life more suitable to their sensory needs.
For instance, for someone who gets overwhelmed by the excessive noise and other sensory input associated with being around people, instead of having a job that requires them to be around others constantly such as working at a fast food restaurant, they might consider a quieter work environment such as working as a stocker at a store or working from home doing a job that requires little contact with people.
Sensory Experiences and Examples
People with autism might experience pain differently than others do. For instance, they might not feel pain as strongly as other people might. Some kids can get a cut and bleed from that cut without even realizing it while other kids might find pain much more excruciating than how other kids their age might experience the same situation.
Some people with autism find certain sounds extremely upsetting or overwhelming. Although most people can probably identify one or a few sounds they really don’t like, people with autism who experience this trait get overly stressed by certain noises. Sometimes the noise that upsets them might not seem to bother anyone else.
Some kids or adults with ASD find certain textures very uncomfortable. They might not be able to cope with wearing certain types of clothing or touching certain items because of the way it makes them feel.
Some people with ASD really like to smell certain things or maybe they find certain smells extremely unpleasant. Other individuals with ASD have an overactive sense of smell which makes life challenging because they are constantly bombarded with smells and this is particularly a problem when they smell things that bother them.
Sometimes this might be perceived as being allergic to something. This may or may not be the case. Always rule out a medical cause if your child does seem to be bothered by certain smells.
Some children either really enjoy or get really bothered by certain visual stimulation. For example, some kids can stare at a flashing light on a toy for a really long time.
Helping Your Child with Their Sensory Challenges
It’s important to consider how your child experiences their sensory input, the stimuli they encounter in their environment that they take through their senses and process through their body.
Consulting with a professional behavior therapist or occupational therapist could be a good option to provide you with more insight and guidance as to understanding how your child processes sensory input.
Some children and adults who tend to be hyperreactive must live in a constant state of intense responsiveness to their sensory world. This can be exhausting, overwhelming, and stressful. There can be a positive side, though, too, as some more intense sensory experiences can be enjoyable for the person if they find the right stimuli, such as finding smells or textures they especially like.
Some people with autism who experience hyperreactivity to sensory input describe the experience of sensations as being both a source of pleasure and a source of pain or discomfort which is why it’s important to truly understand your child’s way of experiencing sensory input and knowing how to help them find more pleasant ways of experiencing sensory input and decreasing their discomfort in ways that are in their best interest.
For children with autism who are more hyporeactive to sensory input, for kids who are less aware of certain sensory stimuli in their environment or in their own body, it’s important for parents, caregivers, and treatment providers to assess and understand this because when these kids overlook certain things in their environment or don’t notice certain things that happen in their own body, problems can arise for the child. For example, if a child doesn’t notice he is hungry or that he is full, he may not eat enough or he may overeat which are both unhealthy and potentially very unsafe for the child.
Addressing Sensory Challenges in Children with Autism
Children with autism likely experience challenges in their daily life related to sensory input and how they process sensory information. They can experience hyperreactivity which means they are likely to be over-responsive to certain sensory input or they can experience hyporeactivity which means they are likely to be under-responsive to certain sensory input.
Sensory input can be anything a person experiences with their senses or within their body from things they see, hear, or smell to things they taste, touch, or experience in their physical body like the sense of being hungry or full, maintaining balance, or being aware of one’s body in the physical space around them.
Every child with autism will have their own way of experiencing sensory input. Some kids may be sensitive to bright lights or loud noises while others may be sensitive to certain clothing textures or certain food textures. Some kids may not notice certain details in their environment or within their body, such as the feeling of being cold even when everyone else around them is wearing a winter coat. Some children might seek out sensory input, such as rocking back and forth, desiring deep pressure hugs, or spinning in circles.
Ways to Help Children with Autism with Sensory Challenges
Some ideas for how to help a child with autism who is hyperreactive to sensory input include these recommendations from Autism Speaks:
- Dimmed lights
- Incandescent versus fluorescent lighting
- Sunglasses or visor to block overhead fluorescent lighting
- Ear plugs or headphones in noisy environments
- Closed door or high-walled work areas to block distracting sights and sounds
- Avoidance of strongly scented products (perfumes, air fresheners, soaps, etc.)
- Food options that avoid personal aversions (e.g., intensely spicy, textured, cold, hot, etc.)
- Clothing that accommodates personal sensitivities (e.g., to tight waistbands and/or scratchy fabric, seams, and tags)
- Request for permission before touching
Ideas for how to help a child with autism who is hyporeactive to sensory input include these recommendations from Autism Speaks:
- Visual supports for those who have difficulty processing spoken information
- Sensory-stimulating toys (e.g., safe chewies and fidgets)
- Opportunities for rocking, swinging and other sensory stimulating activities
- Strong tasting and/or textured foods, cold beverages, etc.
- Firm touch (according to preference)
- Weighted blankets
- Fun opportunities to practice physical skills (catching, dancing, jumping, running, etc.)
- Furniture arrangements that reduce chances of bumping into sharp or hard surfaces
Therapy to Support Children with Autism with Sensory Challenges
Children with autism spectrum disorder who experience sensory challenges can receive effective intervention.
Applied behavior analysis provided by an experienced Board Certified Behavior Analyst is one option for helping your child navigate his sensory world in a way that will be in his best interest now and in the future. He or she can learn effective ways of responding to both pleasant and unpleasant sensory input and how to use different strategies to manage their sensory needs.
An occupational therapist can also assist with this. An occupational therapist can help you better understand your child’s sensory needs and sensory processing tendencies. They can also help your child develop strategies to meet his or her sensory needs on their own.
Speech therapists can help children with sensory challenges that are related to speech, swallowing, and mouth muscle movements.
Autism Speaks. (n.d.) Sensory Issues. Retrieved August 20, 2021, from https://www.autismspeaks.org/sensory-issues
Elwin, M., Schröder, A., Ek, L., Wallsten, T., & Kjellin, L. (2017). Sensory clusters of adults with and without autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(3), 579-589. doi:http://dx.doi.org/10.1007/s10803-016-2976-1
Elwin, M., Ek, L., Kjellin, L., & Schröder, A. (2013). Too much or too little: Hyper- and hypo-reactivity in high-functioning autism spectrum conditions. Journal of Intellectual & Developmental Disability, 38(3), 232-241. doi:http://dx.doi.org/10.3109/13668250.2013.815694
Merriam-Webster. (n.d.). Hyporeactive. In Merriam-Webster.com medical dictionary. Retrieved August 20, 2021, from https://www.merriam-webster.com/medical/hyporeactive