Help for Sensory Hypersensitivity in Autism, ADHD, and Tourette Syndrome
I have learned that no one treatment or intervention can be expected to “cure” an individual diagnosed with autism, Tourette syndrome (TS), or an attention disorder. But I’ve seen that improvement often accompanies the use of nondrug therapies and that a multifaceted approach can be beneficial, particularly when dealing with sensory defensiveness.
As a behavior consultant, I help teachers develop motivational programs for children who receive special education services. I have also raised two children who developed TS at an early age. I’ve combined some of the most helpful practices from my work in the classroom with alternative therapy approaches learned from my own family and from the parents of children I work with.
Two occupational therapists, Jean and Pat Wilbarger, provide this description: “The tendency to react negatively or with alarm to sensory input that is generally considered harmless or nonirritating is typical of sensory defensiveness. Common symptoms may include oversensitivity to light, unexpected touch, and sudden movement, or overreaction to unstable surfaces, high-frequency noises, excessive noise or visual stimuli, and certain smells” (Sensory Defensiveness in Children aged 2-12: An Intervention Guide for Parents and Other Caretakers).
The individual with sensory defensiveness may become overstimulated by noises, tastes, smells, or even types of clothing that are easily accepted by others. A clothing tag, the smell of garbage, or a crowded and noisy hall may quickly send this person into overload. Once in overload, the individual’s symptoms, including tics or self-stimulatory behaviors, tend to increase. He or she is also more likely to shut down or explode in anger.
Symptoms of Sensory Defensiveness
Mild: Most individuals who have mild sensory defensiveness do not recognize their irritation, although others may view them as a little eccentric or neurotic. Losing sunglasses on a bright day might provoke anxiety for such a person. He or she might insist on 100% cotton clothes, with an open neckline. Family members have learned that approaching this person from behind with a surprise hug might lead to an explosive reaction.
Moderate: Sensory defensiveness falls in the moderate level when two or more aspects of the individual’s life are directly affected by normally innocuous stimuli. Attentional abilities in school are typically affected, as are social relationships. There may be idiosyncrasies in the self-care area. Having someone else brush his or her hair, feeling the sting of water while showering, being jostled in line, or navigating through crowds can trigger alarm reactions.
Severe: The highest level of sensory defensiveness can affect every aspect of life. Those with autism, pervasive developmental delay, and schizophrenia often fall into this category. Sensations can trigger extreme reactions that often interfere with typical school interventions and other treatment methods. These individuals experience a strong need to avoid certain sensations.
Being overheated or thirsty is the quickest route to overload. Other stressors include the auditory, visual, touch, taste, smell, and movement systems.
Auditory: hypersensitive to loud or unusual noises (sound of surf on vacation);
Visual: hypersensitive to bright, glaring sunlight;
Touch: bothered by tags or uncomfortable seams on clothing, irritated
by being jostled in crowds, sensitive to certain food textures (e.g. slimy Jell-O; soft fresh fruits; chewy nuts, fuzzy peaches);
Taste and Smell: hypersensitive to different tastes and odors (natural and chemical);
Movement: increased stress when riding escalators, walking down open stairs, or swinging.
Learning to recognize the behaviors that signal your child is close to overload is only the first step. Next, the child needs to learn to recognize and label those signals. Only then will he or she begin to feel a sense of self control. We found the word “tense” was a simple way to describe our children’s feeling of overload.
For example, when a tantrum would suddenly erupt after my child was playing outside on a sweltering hot day, I would say, “You’re feeling tense right now. It’s hot and you need a drink of cool water. Let’s go inside and cool down.” Although as a parent it’s difficult to remain calm and use specific language in the midst of a temper tantrum, it’s important. It was only after such situations that one of my children spontaneously said, “I’m tense” instead of exploding.
Eliminating Secondary Stressors
Defensiveness can be triggered by allergies, sugar, illness, hormonal fluctuations, constipation, too little sleep, and new experiences (like a move to a different classroom or home).
Further, children begin to “tune out” or “act out” when tasks are too difficult for them. When learning becomes frustrating, self-stimulatory behavior or tics are likely to increase. Ability grouping is currently discouraged in many of this country’s classrooms. This practice of keeping the entire class working on the same material in subjects like math and reading frustrates children who move slower or need more practice. I enrolled my children in a school where they would be working at their own pace, challenged without being frustrated.
Relaxation Strategies in Home and School
Occupational therapists have been my best source for sensory activities that promote relaxation. Occupational therapists also recommend total-body activities that require heavy work from the muscles to help reduce the feeling of overload. I recommend including a few of the types of activities listed (see below) into each day’s schedule.
To be effective, these activities sometimes need to be followed by a short quiet period. Because any of these activities can potentially be overstimulating, the parent or teacher should carefully observe the child’s behavior after the activity to determine if it increased, rather than decreased, sensory overload Wilbarger’s brushing regimen, followed by joint compression, is one of the most time-efficient, long-lasting methods of relaxation. It’s a calming approach to begin or end each day. In my own experience, this technique appeared to reduce what had been a high level of oppositional behavior.
Providing a Retreat
It’s also important to have a quiet place in the classroom and home for the child to go and do independent work or pull things together. This is not for punishment but, rather, is a strategic place of retreat. For younger children, a tent filled with pillows serves as a calming area. A quiet carrel desk facing a classroom wall or located in a quiet spot in the nurse’s office can be helpful for an older child.
Initially, I was concerned that making adaptations like these would spoil my children and keep them from developing self-discipline or self-control. But as they grew older and I had the satisfaction of watching them play or work without the angry outbursts and multiple tics they had experienced in the past, I realized how important my role in adjusting their environment had been. My children are now able to identify and avoid these triggers themselves. I’ve met some adults with TS who are successful in making these types of environmental changes for themselves, often without realizing why they are doing it. In some ways they are simply avoiding the insanity of twentieth-century stimuli.
Techniques to Reduce Sensory Stressors
Our family found these approaches helpful. Families can make their own lists after identifying triggers for sensory overload in their children.
- Teach children to use sunglasses on a bright, sunny day
- Sit far away from visually stimulating events, like fireworks and light shows
- Cut tags off clothing
- Wash new clothes a few times before wearing
- Plan relaxing vacations
- Avoid crowded amusement parks and malls
- Keep chilled juice boxes or water bottles in the car
- Spend limited time outdoors on extremely hot days unless water activities are involved
Activities That Can Promote Calming
- Jumping (trampoline, “crash” jumping up and down on the entire bottom of the foot, jump rope, hopscotch)
- Air-blowing (playing a horn or woodwind instrument, exercise of blowing “slow and strong like a lion”)
- Climbing (on a jungle gym, up stairs on hands and knees, through an obstacle course)
- Physical treatments (Wilbarger’s brushing regimen, joint compression, massage)
Mary Damer has educated thousands of families on integrative approaches to sensory sensitivities.