Sensory Issues And Autism

This extensive guide is designed to delve deep into the complex relationship between sensory processing difficulties and autism spectrum disorder (ASD). From hypersensitivity to hyposensitivity, the sensory experiences of individuals with ASD cover a broad spectrum.

In this resource, we aim to provide a thorough understanding of these sensory challenges, the latest research findings, available treatment options, and supportive strategies, among others.

Navigate through our “Sensory Superpage” to gain an understanding of sensory issues in autism and arm yourself with the knowledge and tools to make a positive difference.

What percentage of people with autism have sensory issues?

The prevalence of sensory issues among individuals with autism is considerably high. Although the specific percentages can vary depending on the studies, it’s generally agreed that most individuals with autism experience some form of sensory processing difficulties.

These sensory issues can manifest as hypersensitivity (over-responsiveness to sensory stimuli) or hyposensitivity (under-responsiveness), affecting how individuals experience sensory inputs such as touch, sound, taste, and light. Research by Leekam et al. explains these manifestations in more detail.

Therefore, understanding and accommodating these sensory sensitivities is critical to providing effective support and care for individuals with autism.

What Is Sensory Processing Disorder?

Sensory Processing Disorder (SPD) is a condition where the brain has difficulty processing information taken in through the senses. Recognized initially in the 1960s by occupational therapist and psychologist A. Jean Ayres, SPD is sometimes seen as a standalone disorder but is also commonly associated with autism. People with SPD may be oversensitive or undersensitive to sensory input or both. They can find it challenging to process and act upon information received through the senses, which can affect daily functioning.

Types of Sensitivities

Food sensory issues can be particularly challenging for those with hypersensitivity. Tastes and textures that seem normal to most people can be perceived as extreme and even unbearable. This can lead to a very restrictive diet and nutritional challenges. Coping strategies may include introducing new foods slowly and using behavioral techniques to increase tolerance gradually.

1. Hypersensitivity to Textures:

   Certain textures can be highly aversive for individuals with food sensory issues. This might include foods that are crunchy, slimy, or have a mixed texture. This texture aversion can lead to avoidance of a wide range of foods, often making the diet less varied.

2. Taste Sensitivity:

   Hypersensitivity can also be related to tastes. Some individuals might find specific tastes particularly strong or aversive. This can include an aversion to bitter foods, very sweet foods, or foods with a strong flavor, like garlic or onion.

3. Smell Sensitivity:

   The smell of foods can also be a sensory issue. Some individuals are incredibly susceptible to the smell of food, and strong odors can cause distress or avoidance.

4. Visual Sensitivity:

   For some, the visual appearance of food can be a factor. This might include a preference for foods of a particular color or a dislike of mixed foods.

People with hypersensitivity may find certain clothing materials and tags extremely irritating. The texture and fit of clothes can cause discomfort or pain.

1. Texture Sensitivity:

   One of the primary aspects of clothing sensory issues is sensitivity to textures. Materials that may feel soft and comfortable to most people can feel extraordinarily rough or scratchy to someone with hypersensitivity. Some individuals may prefer certain fabrics like cotton and avoid others like wool or synthetic materials.

2. Tags and Seams:

   One of the primary aspects of clothing sensory issues is sensitivity to textures. Materials that may feel soft and comfortable to most people can feel extraordinarily rough or scratchy to someone with hypersensitivity. Some individuals may prefer certain fabrics like cotton and avoid others like wool or synthetic materials.

3. Fit and Tightness:

   One of the primary aspects of clothing sensory issues is sensitivity to textures. Materials that may feel soft and comfortable to most people can feel extraordinarily rough or scratchy to someone with hypersensitivity. Some individuals may prefer certain fabrics like cotton and avoid others like wool or synthetic materials.

4. Temperature Regulation:

   Sensitivity to the temperature and the weight of the fabric can also be a concern. Some individuals might be very sensitive to being too hot or cold and have strong preferences regarding the weight and warmth of clothing.

5. Sensory-Friendly Clothing:

   Individuals might prefer wearing soft materials and avoiding clothes with tags or tight elastics to cope. Some brands specialize in sensory-friendly clothing. These garments often feature flat seams, tagless designs, and soft, stretchy fabrics.

This form of sensory hypersensitivity involves an intense reaction to the feel of different surfaces and materials.

1. Broad Range of Textures:

   Texture sensitivity is not limited to just fabrics or food but can extend to any tactile experience, including surfaces like carpet, sand, grass, or even the pages of a book.

2. Intensity of Reaction:

   For someone with texture sensitivity, textures that seem benign to others can cause extreme discomfort or distress. This might range from a mild annoyance to feeling overwhelmed or in pain.

3. Impact on Social Interaction and Learning:

   Texture sensitivity can impact social interactions and learning, especially for children. For instance, a child might avoid playing with certain toys or participating in arts and crafts, which can be isolating and limit learning experiences.

4. Sensory Integration Tools:

   Sometimes, sensory integration tools like brushes can help desensitize the skin and improve tolerance to different textures.

Touch sensitivity, or tactile defensiveness, refers to an unusual or increased sensitivity to touch or physical contact. Touch sensitivity can cause normal sensations, like a light touch on the shoulder or a tag in a shirt, to feel uncomfortable or even painful. This overreaction can be mild or severe, and the contact that triggers it can be from a person, an object, or even the individual’s own movements. This condition can significantly impact daily routines and quality of life.

1. Physical Manifestation:

   Individuals with touch sensitivity can have a variety of physical reactions, ranging from withdrawing from touch to experiencing an emotional meltdown or feeling physical pain.

2. Impact on Daily Life:

   Touch sensitivity can affect many aspects of life, such as personal hygiene, clothing, and social interactions. Individuals might have difficulty with tasks that involve touch, like brushing teeth or hair, bathing, or being in crowded spaces.

3. Impact on Relationships:

   Touch sensitivity can also affect relationships, as individuals might withdraw from affectionate touch or avoid physical contact, making interpersonal relationships challenging.

4. Coping Strategies:

   Coping strategies for touch sensitivity can involve managing the environment and building tolerance. Managing the environment might include using special clothing, adjusting the room temperature to avoid sweating or shivering, or even avoiding crowded spaces. Building tolerance often involves a gradual exposure approach, where the individual is slowly introduced to different types of touch in a controlled, non-threatening way. Some prefer deep pressure to light touch and may benefit from pressure garments or weighted blankets.

Noise hypersensitivity, or hyperacusis, refers to an increased or abnormal sensitivity to ordinary environmental sounds. Loud or sudden noises can be particularly distressing for individuals with hypersensitivity. Ordinary sounds, like the hum of a refrigerator, traffic, or people talking, are perceived as uncomfortably loud or even painful. Some individuals might also have difficulty filtering out background noise, making it hard to focus on a single conversation or task.

1. Physical and Emotional Reactions:

   Physical reactions to noise hypersensitivity can range from covering the ears to experiencing pain. Emotional reactions can include anxiety, agitation, and even panic attacks. Over time, the anticipation of loud noises can lead to heightened anxiety and avoidance behaviors.

2. Impact on Daily Life:

   Noise hypersensitivity can affect many aspects of life, from school or work performance to social interactions. Individuals might avoid noisy environments like restaurants, school cafeterias, or busy streets, which can lead to isolation. The sound of a vacuum cleaner, a dog barking, or a car horn can cause anxiety or fear.

3. Coping Strategies:

   There are several strategies for managing noise hypersensitivity. These might include using noise-canceling headphones, creating quiet spaces at home or school, or gradually desensitizing to certain sounds. Even soft or high-pitched sounds can be intense and distressing for those with sound sensitivity. Sound therapy, which involves listening to certain sounds to help the brain improve its processing of auditory stimuli, can be beneficial.

Light hypersensitivity, or photophobia, is a condition in which individuals are sensitive to certain types of light or brightness levels. Light hypersensitivity involves discomfort or pain from exposure to light sources that most people would find normal or tolerable. This could range from sunlight to fluorescent light, from the glow of a computer screen to the harshness of a headlight. It may lead to severe migraines, eye strain, or other physical discomfort.

1. Impact on Daily Life:

   Light hypersensitivity can significantly impact daily life. It may lead to avoidance behaviors, such as shying away from outdoor activities during daylight hours, working in dimly lit spaces, or avoiding places with fluorescent lighting, like supermarkets or classrooms. This avoidance can, in turn, impact social interaction, school performance, and overall quality of life.

2. Coping Strategies:

   Strategies for coping with light hypersensitivity often involve modifying the individual’s environment to reduce exposure to problematic light sources. This might include wearing sunglasses or hats outdoors, using light-dimming screens on electronic devices, or replacing fluorescent lights with softer, indirect lighting. Sunglasses, hats, and natural light can help alleviate discomfort.

Visual hypersensitivity, or hypersensitivity to visual stimuli, can significantly impact how individuals perceive their environment and interact with others. Visual hypersensitivity involves an intense reaction to visual stimuli, such as bright lights, rapid movements, or visually complex environments like crowded rooms or patterned wallpapers. Individuals may be susceptible to specific colors or have difficulty filtering out irrelevant visual information, making it hard for them to focus on the task at hand.

1. Impact on Daily Life:

   This sensory issue can influence many aspects of daily life. For example, individuals may find it hard to concentrate in visually busy environments, have difficulty with tasks requiring visual discrimination, or be easily overwhelmed by rapid visual stimuli, such as action-packed movies or video games. This can impact academic performance, social interactions, and leisure activities.

2. Coping Strategies:

   Strategies for managing visual hypersensitivity may involve minimizing exposure to overwhelming visual stimuli, providing visual breaks throughout the day, and creating visually calm spaces at home or school. Visual schedules or organizers can also help individuals plan and predict their day, reducing anxiety. Creating a visually calm environment, using solid colors, and avoiding patterns, can be helpful.

People with water hypersensitivity have an intense reaction to the sensation of being wet. This might include discomfort or distress when their skin comes into contact with water, whether from rain, bathing, swimming, or even sweat. For some, even the feel of damp clothes or towels can be unbearable.

1. Impact on Daily Life:

   This sensory issue can influence many aspects of daily life. It can make personal hygiene tasks like bathing and brushing teeth very stressful and cause anxiety about outdoor activities when it’s raining or when there’s a possibility of getting wet. It also has the potential to hinder a person’s ability to learn to swim or participate in water-based activities.

2. Coping Strategies:

   Strategies for managing water hypersensitivity may involve gradual exposure to the sensation of being wet, starting with brief, positive experiences involving water, such as playing with water toys or using a spray bottle. For bathing, it can help to ensure the water temperature is comfortable, use soft towels for drying, and allow the individual to enter and exit the water at their own pace. Distraction techniques can be helpful, like singing a song or playing a game during bath time. Waterproof clothing and quick-drying fabrics can make rainy days more manageable. Gradual exposure and making the experience enjoyable by adding toys or using a favorite towel can be beneficial.

Vestibular sensitivity, often experienced by individuals with autism spectrum disorder (ASD), refers to a heightened sensitivity to movements and changes in head position. The vestibular system, located within our inner ear, helps us maintain our balance and understand our body’s position in space. People with vestibular hypersensitivity may have an intense reaction to movement activities like swinging, sliding, or even simply walking or running. They may also feel overwhelmed by quick changes in head position, such as looking up or down.

1. Impact on Daily Life:

   This sensitivity can influence many aspects of daily life. Activities that might seem fun and pleasurable to most people, like playing on playground equipment or participating in sports, might feel scary or uncomfortable. It may also affect an individual’s balance and coordination, making them seem clumsy or fearful of certain activities.

2. Coping Strategies:

   Therapeutic interventions, such as vestibular rehabilitation therapy, can help manage vestibular sensitivity. This form of treatment involves activities that expose the person to controlled movements and changes in head position, allowing them gradually build tolerance and become more comfortable with these sensations. Sometimes, providing alternative options for physical activity that don’t trigger the vestibular system can be beneficial. Yoga or gentle stretching can provide physical activity without triggering intense vestibular responses. Therapies like physical and occupational therapy can help patients build skills in balance and coordination.

Proprioceptive hypersensitivity involves a heightened sensitivity to the sense of body position and movement. The proprioceptive system provides information about the relative position of our body parts and the force we’re applying through our muscles and joints. Individuals with proprioceptive hypersensitivity may find it difficult to gauge the force or pressure required for tasks or struggle to navigate their bodies through space.

1. Impact on Daily Life:

   Proprioceptive hypersensitivity can lead to clumsiness, difficulty with fine and gross motor tasks, and even unusual posturing. Simple activities like eating with utensils, writing, or playing sports can become challenging. Individuals might appear clumsy, bump into objects more often, or have difficulty judging distances. Those with proprioceptive hypersensitivity might struggle to gauge the force needed for tasks such as holding a pen or hugging.

2. Coping Strategies:

   Therapy for proprioceptive hypersensitivity often involves providing plenty of opportunities for ‘heavy work’ activities. These activities provide deep pressure to the muscles and joints, such as lifting, pushing, or pulling heavy objects, jumping on a trampoline, or even doing chores like vacuuming or carrying groceries. Using tools like weighted blankets or vests, exercise resistance bands, or chewy toys can help provide the proprioceptive input these individuals need.

Interoceptive hypersensitivity pertains to heightened sensitivity to internal bodily sensations like hunger or the need to use the bathroom. Interoception is the sense that helps us understand and feel what’s happening inside our bodies. This includes sensing hunger, thirst, digestion, temperature, heartbeat, and more. Individuals with interoceptive hypersensitivity may have heightened awareness of these internal sensations, which can lead to discomfort or confusion. Individuals with interoceptive hypersensitivity may have difficulty recognizing or interpreting these inner signals.

1. Impact on Daily Life:

   Interoceptive hypersensitivity can cause significant distress. It may manifest as anxiety or panic due to the heightened awareness of internal body processes like heartbeat or breathing. It can also lead to difficulties recognizing and interpreting signals like hunger or fullness, needing to use the restroom, or feeling hot or cold.

2. Coping Strategies:

   Coping strategies for interoceptive hypersensitivity often involve learning to interpret body signals accurately. Individuals can benefit from treatments like cognitive behavioral therapy (CBT), for instance. This treatment helps individuals understand their body signals and manage the associated anxiety. Strategies such as scheduled eating or bathroom breaks can help.

3. Mindfulness Techniques:

   Mindfulness and grounding techniques can help manage interoceptive hypersensitivity. This can involve focusing on external sensory experiences, like what one can see or touch, to help draw attention away from overwhelming internal sensations.

Hyposensitivity is a sensory processing issue where an individual is under-responsive or has a lower-than-average response to sensory stimuli. Hyposensitivity can manifest in many ways. An individual may seem unaware of their surroundings, appear clumsy, or may not respond to pain or extreme temperatures as expected.

They may also have a high pain threshold, not realize when they’re being touched, or not notice certain smells or tastes. They may not react to danger as quickly as others due to their muted response to sensory inputs. For example, they might not pull their hand away quickly if they touch something hot.

When people with sensory processing disorders receive too much sensory information, they can experience sensory overload. This might be a loud environment, a crowded space, or a situation with too many different types of stimuli. It can cause severe anxiety, meltdowns, or physical symptoms like nausea or headaches. This is why many people with sensory issues find it beneficial to have a quiet, controlled environment to retreat to when needed.

Sometimes, the challenge is not just the intensity of sensory inputs but also their interpretation. Individuals with sensory processing disorders might have trouble determining where a touch is coming from or distinguishing between different sounds in a noisy environment. This could lead to motor coordination, balance, and spatial awareness difficulties.

These sensory challenges can affect social interactions, academic or work performance, and general well-being. They might lead to anxiety or distress, create barriers to participation in typical activities, and even result in social isolation.

Classroom accommodations are as necessary as academic instruction for children with sensory issues. This might include providing a quiet space for breaks, using visual schedules, providing seating options such as stability balls, and incorporating movement breaks. Some of the more common strategies include:

Diet can play a role in managing sensory issues. Some individuals might have sensitivities to certain foods or find certain textures aversive. Working with a nutritionist to develop a balanced diet that considers these sensitivities can be beneficial.

1. Sensitivities and Allergies:

   Some individuals with sensory issues might also have food sensitivities or allergies, such as to gluten or casein, which are proteins found in wheat and dairy products, respectively. There is some evidence to suggest that a gluten-free and casein-free diet might alleviate some symptoms in children with autism and sensory processing disorders.

2. Texture and Taste Sensitivities:

   Certain textures or tastes can be unbearable for individuals with hypersensitivity. This can lead to a very restricted diet, as they might only accept foods with a specific texture or flavor.

3. Nutritional Balance:

   It must be ensured that individuals receive a nutritionally balanced diet despite the restrictions. Consulting a dietitian or nutritionist familiar with sensory issues can be highly beneficial. They can help devise meal plans that are both acceptable to the individual and nutritionally complete.

4. Incorporating New Foods Gradually:

   Introducing new foods should be a slow and gradual process for those with sensory issues. It can be helpful to introduce new foods alongside familiar ones in small portions and without pressure.

5. Sensory Activities Around Food:

   Sensory play activities involving food can sometimes be helpful. For example, having a child help with cooking can expose them to new textures and smells in a non-threatening way.

6. Consideration of Food Color and Presentation:

   Sometimes, the issue might not be taste or texture but the color or way the food is presented. Paying attention to these aspects might make certain foods more acceptable.

7. Supplements:

   In cases where dietary restrictions are significant, a healthcare professional might recommend vitamin or mineral supplements to ensure that individuals get the necessary nutrients.

8. Hydration

   Sometimes, sensory sensitivities can cause aversion to certain beverages; it’s important to find alternatives to ensure adequate hydration.

The connection between gut health and sensory issues, particularly in individuals with autism spectrum disorders, has been a growing area of interest and research. The gut-brain axis, which refers to the bidirectional communication between the gut and the brain, plays a crucial role in modulating behavior and sensitivity to environmental stimuli. Some aspects of this topic include:

1. Gut Microbiome:

   The gut microbiome comprises trillions of microorganisms, including bacteria, that live in our digestive tract. It plays a significant role in digestion, immune function, and mental health. Evidence suggests that the gut microbiome of individuals with autism is different from neurotypical individuals.

2. Gastrointestinal Issues:

   Many individuals with sensory processing disorders and autism experience gastrointestinal issues such as constipation, diarrhea, and abdominal pain. These issues might exacerbate sensory sensitivities and affect behavior.

3. Probiotics:

   Probiotics are live microorganisms that aid with digestive health. Some studies have suggested that taking probiotics to promote a healthy gut flora balance can be helpful for individuals with autism and sensory processing disorders, possibly by reducing gastrointestinal issues and modulating the immune system.

4. Diet and Gut Health:

   As previously mentioned, diet plays a significant role in gut health. A diet that is high in fiber and includes a variety of fruits and vegetables can promote a healthy gut microbiome. On the other hand, a diet that is high in processed foods and sugar can harm gut health. There is some evidence to suggest that improving gut health can have apositive impact on behavior and sensory processing. For example, reducing gastrointestinal discomfort might result in reduced pain and irritability, which could, in turn, reduce sensory sensitivities.

5. Ongoing Research:

   It’s important to note that research on the gut-brain axis and its role in sensory issues and autism is ongoing. While there is promising evidence, more research is needed to understand the connection fully and to develop effective interventions.

Specific vitamins and supplements have been suggested to have a role in managing sensory issues, especially among individuals with autism spectrum disorder (ASD). This is based on the understanding that nutritional components can affect brain function, behavior, and sensory processing. Some supplements to consider include:

1. Omega-3 Fatty Acids:

   Omega-3 fatty acids, like EPA and DHA, are known for their role in brain health. Some studies have suggested that Omega-3 supplements can improve symptoms of ASD, including sensory issues. These fatty acids might affect neuronal function and reduce inflammation, which could be beneficial.

2. Vitamin D:

   Some evidence suggests that Vitamin D can play a role in autism and sensory issues. Vitamin D is known to have many functions in the brain, and a deficiency in Vitamin D has been observed in many children with ASD.

3. Magnesium and B6:

   Some studies have suggested that combining magnesium and vitamin B6 can reduce irritability and improve social responsiveness in children with ASD, which might indirectly affect sensory processing.

4. Multivitamins and Minerals:

   A general multivitamin and mineral supplement might benefit some individuals with sensory issues, especially if there are any nutritional deficiencies. While vitamins and supplements can be beneficial, having too much of a good thing is possible. Some vitamins can be harmful in excess, and some supplements can interact poorly with other medications or supplements. As always, consult a healthcare provider before starting any new supplements. This is especially true for individuals with sensory issues or ASD, who might be more sensitive to changes in diet or supplements.

5. Individual Differences:

   There is significant individual variability in how people with sensory issues or ASD respond to vitamins and supplements. What might be helpful for one person might not have the same effect on someone else.

6. Holistic Approach:

   Supplements should be part of a holistic approach to managing sensory issues, including behavioral interventions, accommodations, and other therapies. While some evidence suggests that certain vitamins and supplements can be beneficial for sensory issues, use them with caution and under the supervision of a healthcare provider. They can be one component of a comprehensive approach to managing sensory issues in individuals with ASD.