Thursday, June 7, 2012

Guest Post: John Mark McDonald

I'd like to introduce a new blogger, John Mark McDonald, an autistic adult who wants to help others with autism, especially adults on the spectrum having difficulty navigating the unstated social rules on the job. This is his first post, but I have no doubt he'll soon have more insightful offerings, so I hope readers will keep a lookout for new posts from him. --Kim

Sensory Issues in Autism

An important thing to remember for people with autism of all ages is sensory stimulation issues. It is well known in the autism community that people with autism can easily be over stimulated by certain things. After that things get a bit fuzzy. I have heard it said that autistic people can be over or under simulated by certain types of stimuli. From my own experience, autistics tend to need a small amount of sensory stimulation of the right type (sensory attraction) and shielding from stimulation of the wrong type (sensory over-stimulation) or overwhelming amounts of stimulation of any type. To make things more confusing, what kind of sensory stimulation is bad and what is good can be different for each autistic person.
Sensory overload can be especially disabling for people with autism. The symptoms of sensory overload vary from person to person. Some of the common effects range from confusion, anxiety, and restlessness to more serious effects like panic attacks, physical pain, physical illness, migraine headaches, paralysis, meltdowns, and breakdowns.
On the other hand, people of autism are well known for "stimming." The most well-known forms of this are repetitive motions or sounds that are used to reassure or entertain themselves. Stimming probably has the worst reputation of all the autistic behaviors because it sets autistic people apart as being "weird, abnormal, or unnatural." This can lead to stimming issues to be treated all out of proportion of their importance, or even worse being treated with fear and revulsion. Yet for people with autism, sensory stimulation can be needed in order for them to be able to function effectively. Therefore, the goal should not be to eliminate sensory stimulation behavior, but to channel it into more appropriate and productive activities.
            Being able to balance sensory issues is critical for any autistic person to be able to function in a "normal" environment. In order to do this, you need to identify what the sensory stimulation issues are for any given autistic person. This is especially difficult on caregivers of nonverbal autistics or autistic children that are too young to talk and analyze their own situation. In this case the only way to figure this out is by observation. Let me give some examples with each sense of both sensory overstimulation and attraction and some possible tools that can be used in either case.
If an autistic person makes noise or screams every time it gets quiet, it may be that they need sound stimulation. Some low background music like classical or ambient could make a great deal of difference. Another idea is fans or other sources of “white noise” to keep things from being “too quiet.”
 On the other hand, if they get upset every time there is a noise (especially sudden ones), this could mean they are being overwhelmed by sound. A pair of headphones that completely cover the ears could be an amazing help to them. I really want to test the effectiveness of a pair of noise canceling headphones with access to both music and a parabolic microphone for controlling audio stimulation.
If an autistic person likes to hide in dark places, or seems reluctant to go out into the sunlight or other bright places, or they shy away from flashing lights or bright colors they may have light sensitivity. A pair of sunglasses, even indoors, can be a real help. Another idea is dimmable lights or indirect lighting. Personally, visual overstimulation is the fastest way to give me a migraine headache.
If they are drawn to the light and things that are brightly colored, they made need more visual stimulation. Bright colors or shimmering, iridescent or spinning things could be very comforting to them.
If an autistic person is constantly rubbing or scratching themselves they may need more tactile stimulation. Even more disturbing signs of the need of tactile stimulation are so-called self injurious behaviors like hitting themselves or head-banging. A sensory stimulation brush such as occupational therapist use could be very helpful. I used to love corduroy pants, embroidered patches, or those old-fashioned 3-D books that had the plastic ridges on them that I could run my fingers over. The idea here is something that is tactilely interesting that they can handle in public and still be considered appropriate. Any suggestions on this would be welcome.
 On the other hand, it is not uncommon to be overwhelmed by things like clothing touching their skin. Warning signs here are things like constantly taking off their clothes, wearing their clothes inside out or rejecting rough blankets or towels. In this case removing clothing tags and making sure the inside lining of the clothing is smooth and not scratchy can be very important. Autistic people who are sensitive to touch often say that light touches leaves an itching sensation that may last long after the touch is over. My son still likes to wear his clothing inside out as often as he get away with it.
 Another thing to watch out for here is sensitive skin. If they are constantly scratching at her skin until it's red and raw, they may be sensitive to things like the chemicals in fabric softeners or the scents in laundry soaps. I have sensitive skin and it leaves me itching nearly constantly and I have to be constantly aware of whether or not it's appropriate to scratch in public.
Smell can also be the big sensory trigger. If they are constantly burying their nose in things, they may be smelling them. In this case scented candles or Glade plugs might be useful. Conversely, they may be overwhelmed by smell. If they avoid the kitchen or rooms that have just been cleaned or any other strong smells, scents may be overwhelming to them. In this case, Frabreze becomes your friend. Sensitivities to smell can often result in an autistic person getting violently ill in the presence of a noxious smell.
The last of the primary senses is taste. Taste is a tricky one because eating is such a sensory rich activity. Eating involves smell, touch, heat, cold, visual appearance, and deep pressure as well as taste. Teasing what is taste and what is other sensory issues can be a bit difficult. To make things even more complex, taste is divided into five sensations: sweet, bitter, sour, salty, and meaty (or umami).  People with autism are notoriously picky eaters. They are often so repelled by certain foods that trying to get them to eat them is like telling them to drink poison. Other times they may get so fixated on a certain food that they don’t want to eat anything else. My son would not eat anything brightly colored for many years. Personally, I can’t eat potato salad because I can’t stand texture of the smooth potatoes with crunchy bits in them. I also love sweet and salty tastes and can hardly stand bitter or sour tastes and can barely taste meaty tastes at all. Just to make things more fun, neither my son nor I can stand hot spices because the burning sensation is completely overwhelming to us.
Beyond the five primary senses, there are other senses that autistic people can be drawn to or are oversensitive to. The sense of balance and motion is one I've seen many autistic people to be drawn to. They tend to love to run, dance, or spin and never get tired of it. On the other hand people who are sensitive to motion may get easily carsick and find things like roller coasters at theme parks to be torturous. I remember that when I was a small boy, I used to spin until I got so dizzy that I fell down, over and over, and it never made me feel ill.
Another obscure sense is deep pressure. Those who are drawn to deep pressure tend to love hugs and massages in infinite amounts, while those who are sensitive to it can hardly stand more than a light touch. This particular overstimulation can lead to a major misunderstanding about an autistic person “rejecting affection,” when in actuality they just can't stand the sensation of deep pressure. There are therapies involving wearing weighted jackets and ankle and wrist weights to help with deep pressure stimulation.
The sensations of heat and cold are also senses. When I was young I could not get enough of warmth. I was forever wearing coats on warm days, never wore shorts even 100º+ weather and could not get enough of long hot showers. It drove my poor mother crazy. I haven't known anyone who's drawn to the sensation of cold, but it should be fairly obvious to spot. Just a couple of notes here, warmth and burning are completely different sensations: I love the sensation of warmth but hated the burning sensation. Also, just because you love warmth does not mean you'll hate cold and vice versa.
There might be other senses that autistic people are drawn to, but these are all I'm aware of. I would also like to remind you that these are simply examples of personal experience and other people eyes seen or read about. There are plenty of other ways in which autistic people show they are drawn to or overwhelmed by sensations. Besides this, they can also be drawn to or overwhelmed by different commendations of sensations. I mentioned that I was drawn to certain rough textures, but this was especially true when I could use them to make a sound that I could hear and could also feel the vibrations as deep pressure. For someone trying to unravel this from outside observation they can be very complex and confusing.
One last thing to note is that sensory issues can and do change over time and the methods of coping certainly change with growth. An autistic child of four may be overwhelmed by touch to the point of never wanting to wear clothes and spend much of their time spinning. The same person at fourteen may have difficulty with eating any food they consider slimy, but loves to run whenever they find room. At the age of twenty-four, the same person may love to wear light, flowing clothing and have become a professional dancer. Some sensory issues disappear over time while others become problematic seemingly out of nowhere.
In any case, sensory issues tend to be a big deal for people with autism throughout their lives. Understanding sensory issues can be key to understanding how to help an autistic person to improve grow and thrive in their environment.

John Mark McDonald

1 comment:

Sheila said...

Great post!! This was my 1st time here and I'm so glad I found it. This post was informative for me. My Kaden is 5 and I try hard to understand him and have patience. It's hard sometimes and all I can do is love him and take it one day at a time. I just Love him, Aspergers and all! I'll be back soon to read more, Thanks!



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