"What advice would you have for parents of an autistic child exhibiting sensory regulation difficulties?"
A child's ability - or inability - to regulate sensation (i.e., the process of noticing, organizing, and integrating information from the environment and the body, and then processing and responding appropriately) significantly contributes to general behavior patterns. Problems with regulating sensory information (e.g., taste, sound, touch, smell, body movement, or body position) may lead to patterns of:
hypo-sensitivity or sensory-seeking behaviors (e.g., needing high levels of sensory input such as a loud noise, firm touch, repeatedly crashing into walls, banging toys in order to register the sensation, etc.)
hyper-sensitivity or sensory-avoidance (e.g., over-reacting to bright lights, loud noises, being held, etc.)
a mixed pattern of sensory-seeking and sensory-avoidance
Asperger's and High-Functioning Autistic kids with poor sensory regulation show a wide range of problems across several domains, including internalizing behavior problems, externalizing behavior problems, problems in many daily activities, and problems in emotional and attention regulation.
Here are some of the behavioral problems associated with sensory processing difficulties:
Academic problems: The youngster may have mild to severe learning disabilities, and problems with generalizing new concepts and skills.
Difficulties with self-regulation: The youngster may have difficulty with mood stability or maintaining an optimal level of arousal. She may be unable to calm herself down after an activity - or get herself going for an activity. Her arousal level may fluctuate minute-to-minute or day-to-day.
Difficulty with transitions: The youngster may throw a temper tantrum, be uncooperative, or experience heightened anxiety when stopping one activity and starting another. Also, he may have a difficult time leaving a particular place or going to the next task of the day (e.g., bath time, bed time, dinner, etc.).
Emotional problems: The youngster may have significant self-esteem issues, be overly-sensitive to criticism, transitions, or stressful situations. Also, she may have difficulty relating to others or understanding her own actions, motivation, or behavior.
Excessive energy level: The youngster may be unable to sit still, constantly on the run, or engage in risky behaviors.
Frequent hand switching: The youngster may not have a dominant hand for writing by age 5, may switch hands often while cutting or writing, or may throw a ball with both hands.
Impulsivity: The youngster may be unable to control impulses (e.g., to jump out of his seat) or his behavior. In addition, he may be aggressive or frequently "blurt" things out without thinking first.
Low energy level: The youngster may appear lethargic, uninterested in engaging in most activities, or be sedentary most of the day.
Low frustration tolerance: The youngster may become upset, yell or throw a temper tantrum at the slightest thing that does not go her way. She may give up on tasks easily if they are difficult for her.
Motor coordination problems: The youngster may appear clumsy, slouch, rest his head on his hands during desk work, exhibit awkward movements, or have frequent accidents.
Motor planning problems: The youngster may have difficulty with sports, riding a bike, doing jumping jacks, clapping, handwriting, balance, using eating utensils, or getting dressed.
Poor eye-hand coordination: The youngster may have sloppy handwriting, difficulty cutting or drawing a straight line, catching a ball, or tying shoes.
Resistance to the unfamiliar: The youngster may experience anxiety or refuse to meet new people, try new foods, participate in new activities, or sleep in a different environment.
Short attention span: The youngster may have difficulty concentrating on one activity or task for any length of time, and she be distracted by every sight, sound, smell, or movement she sees.
Social skills deficits: The youngster may have a difficult time relating to his peers and sharing. He may isolate, get aggressive, and be overpowering or bossy in order to help himself regulate and to control his sensory environment.
Uncooperative with activities of daily living: The youngster may have difficulty brushing his teeth, eating, participating in certain activities, getting dressed, going to bed, or taking a shower.
A child's sensory sensitivities will indeed affect his or her behavior and general temperament, but the reverse can also be true (i.e., the child's temperament may affect how well or poorly he/she deals with sensory sensitivities). Here are 9 temperaments that may be associated with either sensory-seeking behaviors or sensory-avoidance:
1. Sensory Limit: This is related to how sensitive your youngster is to physical stimuli (e.g., sounds, tastes, touch, temperature changes, etc.), and refers to the amount of stimulation needed to elicit a response (positive or negative) in him or her. For example:
Is your youngster a picky eater, or will he eat almost anything?
Does he startle easily to sounds?
Does he respond positively or negatively to the feel of clothing?
Does your youngster react positively or negatively to particular sounds?
2. Predictability: This trait refers to the regularity of biological functions (e.g., appetite and sleep). For example, does your youngster get hungry or tired at predictable times, or is he or she unpredictable in terms of hunger and tiredness?
3. Perseverance: This is the length of time your youngster persists in activities in the face of difficulty. For example:
Is she able to wait to have her needs met?
Does she react strongly when interrupted in an activity?
Does she persist in an activity when she is asked to stop?
Does your youngster continue to work on a puzzle when she has problems with it, or does she just move on to another activity?
4. Disposition: This is the tendency to react to things primarily in either a positive or negative way. For example:
Is your youngster generally serious?
Is he generally in a happy mood, or does he tend to focus on the negative aspects of life?
5. Emotional Energy Level: This is the intensity of a response, whether positive or negative. For example:
Does your youngster get upset in a very strong and dramatic way, or does he just get quiet when upset?
Does he react strongly and loudly to everything - even relatively minor events - or do most things seem to roll off of his back?
6. Physical Energy Level: This refers to how active your youngster is in general. For example:
Is he always on the go, or does he prefer sedentary quiet activities?
Is your child content to sit and quietly watch?
Does she have difficulty sitting still?
Does your child seem to always wiggle, squirm or pace?
7. Attention Level: This is the degree of concentration and paying attention exhibited when your youngster is not particularly interested in an activity. This characteristic refers to the ease with which external stimuli hampers the ongoing behavior. For example:
Does he or she become sidetracked easily when attempting to follow routine or working on some activity?
Is your child easily distracted by sounds or sights?
Is your child easily soothed when upset by being offered an alternate activity?
8. Approach/Withdrawal: This refers to the youngster’s typical response to strangers or a new situation. For example, does she eagerly approach new situations or people, or does she seem hesitant and resistant when faced with new situations, people or things?
9. Flexibility: This is related to how easily the youngster adapts to changes and transitions (e.g., switching to a new activity). For example:
Does he take a long time to become comfortable in new situations?
Does he have difficulty with changes in routines, or with transitions from one activity to another?
Sensory processing difficulties in kids on the autism spectrum often have a significant impact on the parent-child relationship. A child experiencing these difficulties can react to his parents or his environment in ways that are unpredictable or seemingly irrational. For instance, a youngster who is overly-sensitive to stimuli can react negatively to the parent's voice or touch, or from a tag in his clothing. As a result, the parent can be confused by the youngster’s reactions - and experience a sense of incompetence in his or her parenting skills.
Moms and dads of kids with sensory processing difficulties report higher levels of parenting stress than parents of "typical" children. As sensory processing difficulties increase in severity, so does the level of parental stress.
Early identification of sensory processing difficulties, and an increase in referrals for occupational therapy, may lead to a reduction in childhood problems and parental stress. Also, new pathways for multi-disciplinary evaluation and treatment that emerge as the mental health field becomes more aware of the signs and symptoms of sensory processing difficulties in kids on the spectrum may lead to a reduction in childhood problems and parental stress.
