Our Approach to Children and Adults with Autism Spectrum Disorder and Sensory Processing Difficulties

By Paula Aquila, Occupational Therapist

Everyone experiences the world a little differently. The same person may even experience the world differently depending on their level of pain, fatigue or in response to a physical/emotional stress.

We experience the world through our senses. Our nervous system receives messages through specialized receptors and relays these messages to the central nervous system where meaning is given to the message. Our brain interprets that the colour is yellow, the sound is loud, the touch is soft, etc. Our brain interprets whether we are moving or still, the direction we are moving and whether we are accelerating or decelerating. In fact, our nervous system is so proficient at this process that we barely think about it unless we have difficulty processing sensation and we need to pay attention.

Many children and adults with autism experience challenges in processing sensory information from their own bodies and from the environment. Sensations, like the sound of classical music, the touch of the bristles of the toothbrush or the brightness of the morning sun through a bedroom window may be so strong and overpowering that a person can feel panicky and need to escape. At this point in time, research has not found the answer to ‘why’ a person has sensory processing challenges. What research does support, however, is that many people on the autism spectrum do have challenges with sensory processing and with making sense of sensory information.

The key to understanding a person’s response to sensation or their need to seek out sensation is to observe with an open mind and without judgement. We can all become detectives to determine possible underlying reasons for a child’s response to the sensation we present when we want to interact.

Many people believe that children and adults on the autism spectrum are not interested in interaction and cannot display the affection expected in interactions. Nothing could be farther from the truth. Children with autism are children who happen to have autism. They still have emotion, emotional needs and a desire to express themselves. They may not be able to do that in a conventional way. Let’s look at some examples of children and adults who may be having difficulty processing sensation that can negatively affect interaction.

Clara is an infant who stiffens and cries each time her parent lifts her up from the crib or changes her position in any way. Her parents may feel that Clara is not happy to see them and doesn’t want to interact with them. Clara may have difficulty processing sensation through her vestibular system. This system gives us information that we use to balance our body and maintain our visual system in a horizontal position. Changes in head and body position due to movement provide input to the vestibular system. Clara may have a very sensitive response to vestibular input and being picked up may send her into a panic. When her parent tells her that she is being picked up, sings a song to give her rhythm to help her calm and support her head while lifting her can make a huge difference to Clara’s response.

Ben hates having his teeth brushed. He runs from the washroom and it usually takes one of his parents to hold him and the other to brush his teeth for it to happen. Each day seems to end in this struggle and Ben’s parent’s wonder why they can’t help him. It may be that Ben has a negative response to touch information and interprets the bristles of the toothbrush as painful. Ben may benefit from a vibrating toothbrush and a warning of when the toothbrush will enter his mouth. He may do better with more control; he tells his parents where to put the toothbrush and can set the time timer to provide an end point. Brush strokes can be counted to ensure there will be an end. The use of a facecloth instead of a toothbrush or a cover for the toothbrush bristles may also help.

Amy leaves the office every time the loud salesman with the low voice comes into the office. Amy has been working in the office for nine months and is mastering many aspects of her job. The salesman feels that Amy doesn’t like him. It may be that Amy has a sensitive auditory system and the pitch and volume of his voice is overwhelming to her. If the salesman changes his voice and speaks with a lower volume, Amy may not become overwhelmed and be able to stay in the office during his visits.

We often make the demand of people with autism to accommodate the environment and ‘put up’ with sensation that they may find overwhelming. This may not be possible. Learning how to support people with autism through a sensory integration ‘lens’ can facilitate the functioning of their nervous system and enable their expression and successful interaction. Understanding that others can perceive sensation differently can help us keep an open mind and problem solve solutions for people on the autism spectrum.