Overcoming Sensory Challenges

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Overcoming Sensory Challenges

• Geoff Evans
• Key Issues in Autism Conference
• Llandudno 12/11/07

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Sensory Overload

• The corridors and halls of almost any mainstream
  school are a constant tumult of noises echoing,
  florescent lights (a particular source of visual
  and auditory stress for people on the autistic
  spectrum) bells ringing, people bumping into each
  other, the smells of cleaning products and so on.
  For anyone with the sensory hyper-sensitivities
  and processing problems typical of an autistic
  spectrum condition, the result is that we often
  spend most of the day perilously close to sensory
  overload.
• (Sainsbury 2000)

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Possible Responses to Sensory Difficulties.

• The F words
• Fear
• Flight
• Fight

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Triad of Impairments
Communication impairments
Impairment of social interaction
Sensory processing
Flexibility of thought and behaviour
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The Sensory Integration Process Register, become
aware of the sensation Orientation, pay attention
to it Interpret,using current information and
referencing past experiences for
comparison Organization, occurs when our brain
decided what to do in response to the
sensation Execution,What we actually do in
response to the sensation
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The only way you will understand is if I put my
brain in your head, then you will see things
properly.
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Sensory Processing Difficulties
The perception of sounds

• My hearing is like having a sound amplifier
  set at maximum loudness. My ears are like a
  microphone that picks up and amplifies sound, I
  have two choices, turn my ears on and get deluged
  with sound or shut my ears off.
• (Temple Grandin)
• A sudden noise (even a relative faint one)
  will make my heart race
• It is impossible for an autistic child to
  concentrate in a classroom, if he or she is
  bombarded with noises that blast through his or
  her brain lile a jet engine.
• Another trick my ears played was to change
  the volume of sounds around me. Sometimes when
  other kids speak to me I could scarcely hear them
  and sometimes they sounded like bullets.
• (White and White)

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• I was living in a world of day dreaming and fear
  revolving about myself. I had no care about
  human feelings or other people. I was terrified
  to go in the water swimming (and of) loud noises.
• (Volkmar and Cohan)
• Many bad behaviours are triggered due to
  anticipation of being subject to a painful noise,
  bad behaviours can occur hours before the noise
• What do autistic children hear ? Sometimes I
  heard and understood and other times sounds or
  speech reached my brain like an unbearable noise
  like on a rushing freight train. Noise and
  confusion of a large gathering of people
  overwhelmed my senses.
• (Temple Grandin)

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Possible Resulting Behaviours

• Becomes upset or runs away from unexpected noise
• Doesnt like the sound of certain electrical
  appliances e.g. vacuum cleaners, kettles. May
  seek to escape or remove items.
• Walks around Humming and or shouting to block out
  unwanted noise. This may cause problems in class
  or out in public.
• Appears to ignore voices or certain sounds may be
  perceived as rude.
• Finds it difficult to shut out unwanted sounds
• Looks confused and doesn't know what sounds to
  pay attention to

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Ways Forward

• Try to provide warning of loud noises
• Ensure that you have the childs attention before
  giving important information
• Provide a visual cue when you want the child to
  listen
• Dont presume that the child can look and listen
  at the same time
• Provide a quite place for the child to retreat to
  in the home or school
• Provide the child with a means of indicating that
  they cant cope with sounds/noise
• Provide the child with earphones to block out
  unwanted sounds

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Ways Forward

• Provide the child with background music to help
  them stay calm. When I am feeling angry and
  despairing of everything, music is the only way
  of making me feel calmer inside. (Jolliffe 1992)
• Provide the child with music to block out
  unwanted sounds
• Vary the tone of your voice to maintain interest
  and gain attention.
• Only have one person at a time speaking to reduce
  stress and misunderstandings.
• Dont have TV, music on at the same time

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VISUAL PERCEPTION

• Spatial perception difficulties
• I used to hate small shops because my eyesight
  used to make them look as if they were ever
  smaller than they actually were. (White and White
  1987)
• Difficulties with colour
• I also remember one Christmas when I got a new
  bike for a present. It was yellow, I would not
  look at it extra orange was added to it and it
  blurred upwards making it look like it was on
  fire.
• Difficulties with light and lights
• Bright lights, midday sun, reflected lights,
  flickering lights, fluorescent lights each seemed
  to sear my eyes. Together the sharp sounds and
  the bright lights were more than enough to
  overload my senses. My head would feel tight, my
  stomach would churn and my pulse would run my
  heart ragged until I found the safety zone. (
  Willey 1999)

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VISUAL PERCEPTION

• It may be because things that I see do not always
  make the right responses that I am frightened of
  so many things that can be seen, people,
  particularly their faces, very bright lights.
  Crowds, things moving suddenly, large machines
  and buildings that are unfamiliar, unfamiliar
  places, my own shadow, the dark, bridges, rivers,
  canals, streams and the sea.
• Jolliffe (1992)

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Possible Behaviour Difficulties

• Sensitive to changes in natural light may find it
  difficult to be outside at certain times of the
  year
• Uses fingers to filter light. This can limit
  involvement in activities can draw attention to
  the child.
• Have difficulties finding what they are looking
  for requiring extra time for activities
• Problems concentrating when in a room with
  fluorescent lighting may engage in flight
  activities.
• Possible difficulties with certain colours may
  avoid them or seek them out.
• Bumps into things and people.

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Possible difficulties

• May prefer to use peripheral vision, in school,
  when talking and listening when crossing roads.
• Inability to distinguish between foreground and
  background (can result in sensory overload not
  gaining all information needed.

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• We can be part of the problem
• People everywhere,
• Talking, wearing bright colours.
• The talking is like the pounding of horses
  hooves.
• The bright colours are blinding,
• The talking hurts my ears,
• The bright colours hurt my eyes.
• Oh why cant people be quiet and wear dull
  colours.
• (Dianne Mear 1994)

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Ways Forward

• Try to identify colours that may cause a problem
  for your child by observation and experimentation
  and controle exposure to them.
• Try breaking up long corridors etc with colour to
  provide a point of focus and so facilitate
  movement.
• Put tape on edges of steps to help with
  processing depth
• Allow to explore new environments
• Have a area with reduced visual stimuli (tent
  within a room)
• Remind the child what and who to look at
• Teach the meaning of facial expressions dont put
  pressure on to look at people.

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Touch

• Some episodes of bad behaviour were directly
  caused by sensory difficulties. I often
  misbehaved in church and screamed because my
  Sunday clothes felt different. During cold
  weather when I had to walk outside in a skirt my
  legs hurt. The problem could have been easily
  overcome by finding Sunday clothes that felt the
  same as every day clothes.
• (Temple Grandin)

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Touch

• Therese Joliffe preferred using touch to learn
  about her environment because it was easier to
  understand things through her fingers. Her
  hearing and vision were distorted and provided
  unreliable information. She was better able to
  see if she felt items first.
• I hated having showers as a child, and preferred
  baths. The sensation of water splashing on my
  face was unbearable. I still hate it. I would go
  for weeks at a time without bathing and was
  amazed when I found out that kids had a regular
  shower, every day even.

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Touch Related Behaviour Difficulties

• Doesn't like the feel of towel on skin or being
  splashed with water can result in avoiding bath
  times or swimming.
• Doesnt like teeth been brushed can result in
  flight,fight or fright behaviours.
• Becomes upset when touched particularly if
  unexpected.
• Doesnt like wearing new clothes or cloths of
  certain textures.
• Doesnt like getting hands dirty or food around
  mouth.
• Avoids activates that involve being touched.

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Ways Forward

• Gradually introduce new clothing over time.
• Involve the child as much as possible with
  washing and bathing, allow the to control how
  much pressure is used.
• Try different lengths of clothing (shirts,
  trousers)
• Heavier blankets or foam mattresses may help with
  sleep difficulties.
• Observe the child's responses to different
  textures in the environment and make adjustments.
• Try to give warning of touch (first we wash your
  hands then your arms)
• Provide opportunities to receive deep pressure.

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Gustatory (Taste)

• Myles et al,(2000) more than one third of
  children with AS
• Avoided certain tastes that are typical
  in children's diets
• Would only eat certain foods
• Were picky eaters
• I hated anything that was slimy, like Jell-O or
  undercooked egg whites.
• Temple Grandin

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Taste

• I had a big problem with food. I liked things
  that were bland and uncomplicated. My favourite
  food were cereal- dry with no milk pancakes,
  macaronis and spaghetti, potatoes and milk.
  Because these were the foods I ate early in life,
  I found comforting and soothing. I didn't want to
  try anything new.
• Canned asparagus was intolerable due to its slimy
  texture, and I didn't eat tomatoes for a year
  after cherry tomato had burst in my mouth while I
  was eating it. The sensory sensation of having
  that small piece of fruit explode in my mouth was
  too much to bear and I was not going to take any
  chances of it happening again
• Stephen Shore

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Possible Difficulties

• Will not eat certain foods
• Maybe sensitive to certain textures and refuse
  them
• May only eat foods of a certain texture

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Ways Forward

• Try to create a relaxed atmosphere at meal times
• Respect individual differences dont try to force
  food on the child.
• Introduce very small bites or portions of new
  food try not to change both textures and tastes
  at the same time.
• Always proceed with caution and take advice

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Olfactory (Smell)

• 75 of young people in Myles study experienced
  some difficulties in this area of olfactory
  sensory sensitivity
• Sensitivity in this area can bring about
  Fright Flight or Fight response

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Possible Difficulties

• Finds it difficult to be in certain environments
  due to smells (may be aware of smells we dont
  pick up on)
• Close proximity of people can be a problem due to
  odours
• Refuses certain foods due to smell.

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Ways Forward

• Use unscented products
• Try to identify smells that cause particular
  problems and remove them from the home for a
  period
• Try to gradually increase tolerance

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Proprioception

• The muscles and joints and joints send messages
  to help us carry out basic movement functions
  such as ,stand, sit, hold things and balance
• This system allows us to carry out movement tasks
  without looking.

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Possible Difficulties

• Difficulty maintaining good posture when sitting
• Visually checks out hands and feet to ensure that
  they are doing right thing
• Shuffles a lot
• Cant get comfortable
• Difficulty climbing and descending stairs
• Gym can be a nightmare
• Difficulty finding his mouth/teeth when brushing
• Difficulty using right amount of pressure when
  writing
• Poor muscle tone

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Ways forward

• Try using heavier items (plates, cups) so that
  they are more easily registered
• Provide visual information for sitting at desk
• Encourage the use of squeeze balls etc
• Provide opportunities for large motor activities,
  pushing, jumping and pulling
• Do activities that that encourage and develop use
  of whole body and coordination
• Consider the type of fasteners on clothing
• Use clay etc to develop hand strength

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Vestibular System

• Vestibular system is involved in movement,
  posture, balance and coordination of both sides
  of the body
• Approximately 50 of children with A S
  experience difficulties in this area
• Can be hyper or hypo sensitive
• Hypersensitive children have difficulties with
  anything that involves movement particularly
  involving changing direction, speed. This group
  can fear having their feet of the ground
  (Gravitationally insecure)

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Possible Difficulties

• Difficulties changing directions
• May find sports difficult
• May have difficulty changing speed
• May be afraid to have their feet off the floor
• May loose their place when reading from a board
• Putting trousers on may cause problems
• May turn whole of body to look at a person
  rather than only head
• Engages in bouncing, spinning