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Sandra brought her new baby Thomas home and noticed at about two weeks of age that if she stroked his face while he nursed, he would pull away and start crying as though he were hurt. The same reaction would occur when Sandra touched Thomas’ arms. He did not have the same reactions to his hands, feet, head, ears, neck or torso. Sandra was a brand new mother and her baby’s reactions concerned her so she decided to make an appointment with her pediatrician.
Sandra’s pediatrician examined Thomas and ruled out any obvious physical reasons for the baby’s strong opposition to having his face and arms touched. He didn’t have any bruising, rash or sunburn. His physical exams were all normal including his bloodwork. So Sandra’s pediatrician suggested that Thomas might have a sensory processing disorder. Sensory Processing Disorder (SPD) is a disorder that causes a child to be over responsive (hypersensitive) or under responsive (hyposensitive) to outside stimuli. The outside stimulus could be any of the following: sights, sounds, smells, tastes, touch, balance or body awareness.
Hypersensitivity to Sound and Smell
Thomas had tactile (touch) hypersensitivity (over-responsive). His little body went into sensory overload when his face or his arms were touched. His only method of response as an infant was to deliver a high pitched cry when he felt overwhelmed by the touching.
As Thomas grew older, he would outgrow one sensory issue and develop another. At the age of three he would cover his ears with his hands when he was exposed to certain sounds or pitches that were bothersome to him. At the age of five, he would cry when exposed to certain smells. For example, as the family drove along the highway a newly tarred asphalt road could easily provoke a screaming tantrum in the car.
Some of the other sensory issues that Thomas worked through included:
- Food textures and colors– at one point he would only eat “white” food such as cottage cheese, yogurt, hard boiled egg (just the egg white- no yolk), milk or string cheese.
- Clothing colors- Thomas would only wear red athletic shirts with the label removed so that he wouldn’t feel irritated by the label.
- Food flavors were dull to him as he grew older and this prompted Thomas to start using an extraordinary amount of salt, pepper, hot sauce, mustard, ranch or any condiment that would spice or flavor the food to the point that it was noticeable and acceptable to him. To those of us without hyposensitivity to flavors, the addition of the condiments was extreme and made the food inedible.
Helping autistic children and teenagers with sensory sensitivities
Needless to say, Sensory Processing Disorders (SPDs) are difficult to navigate in so many ways. Identifying the issue is the first step. Working with the issue or around the issue is the next step. Many of these sensory issues are temporary and seem to disappear suddenly. Others are more permanent and require some sort of compromise to work through.
Eating white food items is an example of a temporary sensory issue that did not require a lot of effort to resolve. Most children will observe other children eating goldfish crackers, chicken nuggets, french fries, fruit, cookies or other yummy looking foods and start to become curious. Sometimes that is enough to move through a phase like the single color food diet.
Clothing colors or labels are an example of something that could be a bit more permanent or at least a very long running season. The closer Thomas gets to adulthood, the more likely he is to start observing his peers and perhaps he will express a desire to buy a certain jacket or shirt of another color. Most parents of a child with autism who is seemingly stuck in a particular “phase” would jump at the chance to provide an alternative. The label irritation will most likely remain an issue- most adults without a sensory perception disorder don’t like the feel of clothing labels against their skin and removing labels from clothing before wearing them is not a big ordeal that will disrupt daily living in adolescence or adulthood.
How Can I Help My Child Overcome SPDs?
The simplest way to help children with autism overcome SPDs is to find opportunities to expose them to the aversive stimuli. If it is a certain food, try presenting it occasionally in small doses or try eating that particular food in their line of sight. If it is a sound, try to find opportunities to expose them to that particular sound. If they react strongly just allow them to leave the area without forcing them to stay or trying to talk them out of feeling overwhelmed.
It’s similar to trying to get a toddler to try a new food. Nutritionists say that it can take as many as 100 exposures to a new food before a child will try it. That means that it may take 100 pieces of broccoli on that toddler’s plate before he/she finally puts it in their mouth to try it. Time and patience are required to work through these issues.
Remember that SPDs work in both directions. Some children might be hypersensitive to touch but more often, children with autism tend to be hyposensitive to touch and enjoy tight hugs and squeezes and even weighted blankets to calm them down during bouts of anxiety.
Whatever your child’s SPDs are, you are not expected to get through this alone. Kudos to the parent that is motivated and dedicated enough to do the research and the hard work of trying to help their child on their own. However, if there are issues that are just too overwhelming to address at home it will become necessary to find professional help.
Most families have a network of professionals that they will be working with as they seek treatment for their child’s autism and sensory processing deficits. The best approach is to have a combination of ABA services, occupational therapy, speech therapy. If necessary a child psychologist can step in and provide cognitive behavioral therapy (CBT) to help a child with autism to work through the aversions to certain stimuli.
ABA therapists and BCBAs are familiar with the signs and symptoms of SPDs and often refer children to trained occupational therapists. Sensory perception is a skill that can be incorporated and learned during ABA sessions. Circle Care Services provides OT and Speech therapy as well as ABA for all encompassing coordinated care.
If you know a child who displays sensory processing difficulty, start by discussing ways of treating SPDs with an autism specialist. Sensory Integration therapy is part of the Social Skills Training that the therapists teach at Circle Care Service’s Kids Club.
The therapists at Circle Care work hand in hand with speech, and occupational therapists or psychologists to help increase tolerance to aversive stimuli or increase awareness of stimuli that your child with autism is not responding to. For example, a child may feel frustration but have difficulty expressing that they need a hug or to calm down by being squeezed or confined to a small space. Learning emotional and body awareness is a big step for children with autism who may lack the verbal skills to articulate their needs.
Give us a call at Circle Care. Let us become a part of your team. Let us help you find the resources you need and get you in touch with the right specialists or social skills groups to meet your child’s needs. Our BCBAs can evaluate and recommend an effective course of treatment for your child. We have a heart for your child and we would love to meet you and connect you with other families in New Jersey.