Having a child diagnosed with an Autism Spectrum Disorder (ASD) necessitates parents to make a host of lifestyle and emotional adjustments. Many of these adjustments are in response to behavioral challenges exhibited by their children due to difficulty appropriately processing sensory information. Children may overreact or underreact to environmental stimuli in unusual ways which affects their responses and dictates behaviors exhibited to help them feel more regulated. The goal of this article is to provide practical advice for parents as they adapt to having a child with unique sensory processing. Research has shown that parents who acquire information regarding their children’s disorders and how to best work with them will more likely benefit from improved and stronger parent-child relationships.
There is a continuous debate regarding the physiological basis for what happens in the nervous systems of children with sensory processing difficulties to cause dysregulation when faced with sensory information from the environment. Nonetheless, it is clear that the central nervous systems of people with ASDs do not consistently effectively integrate sensory information, where the central nervous systems of typically developing individuals automatically organize and properly interpret sensory information (Murray, 2009). Therefore, it is helpful for parents to understand that many of the behaviors exhibited by children with sensory processing difficulties are out of their control and to, accordingly, restructure their own thinking to a “can’t versus won’t” philosophy. As parents increase understanding that their children’s responses stem from difficulties not fully in their control, the more likely their patience will increase for their children’s sensory difficulties (Dix, 1993).
The behavioral presentations of children with sensory integration difficulties can be classified into two categories. Some children are sensory seekers, meaning they have lower levels of arousal and their nervous systems require more input to reach satiating thresholds. Therefore, they seek input and sensation from their environment and engage in behaviors such as flapping their arms or hands, asking for excessive food, or moving around and spinning. On the other hand, sensory aversive children have higher levels of arousal and are more easily overwhelmed by stimuli in their environment. They try to decrease the effects of sensory input by engaging in activities such as chewing on items in the environment, withdrawing to small spaces, covering their ears, and squeezing their body parts. It is also possible for some children to be sensory aversive in one area, yet sensory seeker in another (e.g., a child might seek out deep pressure, but find loud noises aversive).
Dr. Temple Grandin, renowned author and professor, who is diagnosed with Autism (1984) has written extensively about her own difficulties processing sensory information. She laments that she wishes her parents understood her sensory sensitivities when she was a child. However, only now as an adult can she articulate what her experiences were like. Dr. Grandin was hypersensitive to some of her clothes and struggled to process their feeling against her skin. She describes that her Sunday church dress “felt like sandpaper on exposed nerve endings.” Certain types of sounds and their accompanying volume and pitch were also painful for Dr. Grandin, “like a dentist’s drill hitting a nerve.” It is no wonder she tried to escape such situations, as do most children with hyper-sensitive sensory systems.
Suggestions for Parents
For parents of sensory aversive children, the following suggestions are offered. Firstly, it is important to remember that sensory aversive children require soothing methods to decrease their arousal in order to feel calm. Examples of ways to decrease arousal include brushing, deep pressure, or being wrapped in blankets. For children who are sensitive to loud sounds, wearing earplugs is recommended to reduce auditory input. Speaking calmly to children in order to prepare them for what stimuli may be approaching can also reduce their anxiety and decrease the chances of their being suddenly overwhelmed. Many children are also soothed by classical music.
Children who are sensory seekers benefit from proactive sensory input. This allows them to organize themselves and align their sensory systems before they engage in inappropriate behaviors to meet their sensory needs. Examples of sensory input include carrying a heavy bag, jumping on a trampoline, or doing wall pushups. Other suggestions include movement breaks to walk or jump in place if a child has been sedentary for a while. Some of these needs can be met in the community to help avoid public tantrums. For example, having sensory seekers be responsible for pushing the cart in the grocery store is a good way for them to receive the input they need to feel regulated. Also, some toys can help reduce fidgeting during times that demand quiet or focus. Examples of these toys include Koosh balls, small stuffed animals, or stress balls. Sitting on a large inflated ball where sensory seekers can move around while completing tasks can also be helpful as it can provide additional sensory input that is often needed to sustain attention to complete tasks.
As parents gain understanding about their children’s sensory dsyregulation, it is essential for them to pay close attention to the specific sensory triggers that unbalance their children. Initially, the triggers may seem arbitrary, but over time parents should be able to identify a pattern. Paying attention to what triggers lead to sensory dysregulation in their children, can help parents minimize or prevent negative reactive behaviors. Knowing triggers can also help parents learn to avoid them whenever possible, as well as help to set goals for sensory integration, desensitization, and behavioral programs. Furthermore, it is vital that sensory triggers be taken into account when shopping for clothing or planning excursions. Occupational therapists can assist with this process. Once triggers are identified they can help create “sensory diets” that parents can follow to help regulate their children throughout the day.
Parents of children with ASDs should also be mindful of time in both the long and short term, as their children often require “more time” than their typically developing peers. In the long term, developmental milestones may not arrive until later, making progress toward achieving goals take longer than anticipated. In the short term, allotting more time to complete tasks, for example morning or bedtime routines, can be very helpful as children with sensory processing difficulties can become upset by stimuli in their environment in an inconsistent manner. Thus, something that is not disconcerting to them one day may be another day. Parents who develop patience with these processes will be less frustrated and experience less pressure when working with their children. Furthermore, allowing extra time to complete tasks in the event that there is a behavioral difficulty that will require addressing can reduce the anxiety of time constraints.
Parents may personalize their children’s sensory needs and aversions, despite the fact that they are merely responding to their own sensory systems. This is especially true for parents of children who are aversive to touch, as this is typically a means of bonding between parents and children, especially in the early stages of life. When their children respond negatively, parents often view this as a rejection of them and their affection. For parents of children with sensory processing difficulties, the best way to communicate love is to speak the children’s “sensory language.” For example, if a child is a sensory seeker, parents can show affection by giving a deep massage, bear hug or vibrating pillow. If a child is sensory aversive, holding up a sign that says “I love you,” giving a high five, or giving them time in a quiet environment can be means of showing affection. Many parents find it helpful to discuss their feelings in individual therapy or in a support group with other parents who are also experiencing similar challenges.
Over time, as parents become more knowledgeable about how to address their children’s sensory needs and triggers, they will observe children with improved behavioral regulation and ultimately, they will experience more mutually gratifying relationships. Identifying whether their children are sensory seekers or sensory aversive and adapting to those needs within various environments, as well as working with professionals to create appropriate sensory integration, desensitization, and behavioral programs are key components to ameliorating difficult behaviors. It can also be helpful for parents to have their own outlet of support in individual or group therapy. The more empowered parents feel and the more tools they have to address their children’s sensory processing difficulties, the more positive the interactions will be and the more bonded the relationships with their children will become.
Sheri Wolnerman-Bardos, MS, is a psychology intern at the Fay J. Lindner Center for Autism. She is pursuing her doctorate in Clinical Psychology at Long Island University: C.W. Post. Natalia Appenzeller, PhD, is Clinical Director at the Fay J. Lindner Center for Autism.
The Fay J. Lindner Center for Autism, an affiliate of the North Shore-LIJ Health System, was formed to meet the needs of children and adults with autism and related developmental disabilities and their families. The Center is located in a state-of-the-art facility on AHRC Nassau’s Brookville campus. The Center offers a wide range of programs, clinical services, professional training, community education, specialized program consultation and research, to individuals, families and schools. Visit us online at www.FayJLindnerCenter.org.