Sara is a six year old who wears the same soft pink dress each day. She is very fussy about her clothes and how the textures feel on her sensitive skin. She will cry easily if made to wear something new. John is an 11 year old who will only eat chicken strips and French fries. At a glance, some may call John a picky eater, but the explanation is more complex. He has a strong preference for foods that are cut lengthwise, just the right size for him to place on the center of his tongue while not touching any other area.
Sara and John are two of many children who experience the symptoms of a sensory processing disorder, also known as sensory integration dysfunction, and defensiveness related to the developmental disorder of autism. A sensory processing disorder (SPD) inhibits a child from reacting to ordinary sensations and experiences in an expected way due to his abnormally functioning central nervous system. Difficulty in processing may be mild to severe. Although every child (autistic or not), may struggle with processing sensory information from time to time, in children with SPD, the struggle interferes with their daily life. A child may be hypersensitive to touch and avoid taking a shower, stepping outside in the rain or walking barefoot in the sand; he may be under-sensitive to movement and find it hard to sit still or get a thrill out of recess activities like jumping on a trampoline, spinning on the tire swing or swinging on monkey bars.
Children with autism do not perceive and integrate senses in the same way as others. There may be a deficiency in processing, interpreting and responding to the world around him. No two children with autism are alike, although there may be commonalities. “Autistic children may have sensory preferences and sensitivities that other children might not have which cause them to display behaviors like flapping hands in front of their face or staring at lights,” said Christina Newendorp, Development Director of the Tulsa Autism Foundation.
This can present a challenge for parents, as sensory issues can be much more than specific clothing or food preferences. A child who is more sensory-seeking than average might find himself in unsafe situations while a child who is less sensory-seeking than average might be disconnected from his surroundings. This makes it important to strive for a balance closer to a normal range of sensory functioning. Steps toward normal sensory functioning include being able to interpret body language, reacting to situations and predicting how someone may feel.
An occupational therapist may help you use a Sensory Profile to identify your child’s preferences and come up with strategies to make you and your child’s life easier. Rene Damon, therapist and director of the Oklahoma Autism Network, recommends that parents work with a professional through early intervention at school or privately. “It is a matter of making accommodations,” Damon says. For example, if your child is oversensitive to touch, you may want to consider which type of clothing and fabric will be most comfortable for him; while some children like deep pressure and others prefer light touch, some children with SPD are painfully sensitive to touch.
To improve your child’s behavior and decrease anxiety, start at home. Some ideas include:
• Make a chart with words or pictures that sequence familiar routines such as bedtime or brushing teeth. “You can make a visual schedule to help your child predict what is coming next and communicate when he is having trouble expressing himself,” explains speech therapist Cathy Ross of Therapy Solutions.
• Maintain structured routines to avoid changes that might frustrate your child.
• Therapeutic Listening is recommended by Mercy Health Center occupational therapist Laura Smith. This strategy uses specially-modulated music over headphones to help children with SPD or autism to process visual information, movement and auditory information at the same time.
• Watch for signals of sensory overload. Try oral input to overcome stress and give your child gum, raw vegetables or Tootsie Rolls to chew on, which he may find calming.
• Provide tangible rewards when your child does something well. Fill a goodie bag with small, meaningful items (such as small toys), and let him choose one as a reward for good behavior. This may properly teach him to identify and react to social, emotional and behavioral cues in his environment while encouraging him to repeat the good behavior.
• Consider an aquarium at home—many children with SPD find soothing comfort in watching the movement of the fish and water. This also provides an opportunity for him to help you to care for the fish and the tank, providing an important sense of responsibility and accomplishment.
Children with SPD should not be mistaken as developmentally delayed; they just require new information to be taught in accordance with their sensory preference.
• Increase your child’s comfort at school by talking to his teachers about ways he can productively manage his sensory deficits. Some things to consider: If your child requires movement to concentrate, he may find comfort in passing out papers, distributing books, sharpening pencils or wiping the chalkboard.
• During silent reading time, it may be easier for him to sit in a beanbag rather than a standard chair.
• It may be calming for an autistic or SPD child to care for the classroom pet.
• Familiar objects may help to provide comfort to your child. Laura Smith encourages including familiar scents on a cotton ball in a small container, a ball or toy to squeeze, small rocks or found objects that have meaning. It may be comforting to take these familiar objects of interest with him through the day.
Be aware of the resources and support available in your community. The Center for Disease Control’s “Learn the Signs, Act Early” campaign provides general child development checklists to assist you in recognizing if you should be concerned about your child’s behavior. You may also want to visit FirstSigns.org to review their child development checklist. Networking with other parents of autistic children can be comforting and helpful. However, you should bring remaining questions to your pediatrician and other health care professionals who may work with your child. Most importantly, remember you are not alone.
Jamie Lober, has a MS in Psychology and through her writing seeks to promote healthy environments, lifestyles and policies with the goal of preventing and managing disease.