Sensory 101

One of the hardest things for many parents to understand about their child with Autism is their sensory issues. I’m writing from my experience, which is with kids who have ASD.  Sensory issues can come on their own, as part of Sensory Processing Disorder, or with another condition such as ADHD.

If you don’t have a sensory issue, it can be very hard to understand why you child is refusing to put on the shirt grandma gave him for Christmas because it “doesn’t feel right”.  Often, parents chalk these tantrums up to behaviour or defiance, but as I explained in an earlier post, behaviour is how some children with ASD communicate that there is a problem. I have some sensory issues myself, but I also have the words to be able to explain why something is bothering me. I primarily have issues with fabrics, foods, and some sounds, so I’ve got it easy.  As an adult, I am able to avoid most of the things that drive me crazy, and as a child I was lucky to have parents who cared only that I was wearing clothes but didn’t care if i wouldn’t wear corduroy, or would only wear corduroy.

Many parents try to make mornings less of a hassle by picking out (or having their children pick out) clothes the night before. While it is a good idea in theory, it can fail horribly in practice for a sensory kid (or grownup) because sometimes something that didn’t bother them yesterday does today.  They aren’t being intentionally difficult; they really cannot handle the stimulation those clothes provide on that day.  It should be noted, too, that in teens and adults hormones and hormone fluctuations can affect sensitivities so they literally can change day to day.

The seams on clothing can be a constant irritant.  Sometimes I am able to filter it out and ignore it but sometimes it’s like a sunburn – my skin feels different and wrong and I can’t concentrate on anything until the situation is fixed.  I need to change clothes.  I have pairs of diabetic socks because they don’t have rough seams and they are non binding – the elastic at the top of socks is awful.   The fabrics themselves may rub the wrong way – and which fabrics bother me may change.  I lived in jeans in high school – I had 4 or 5 pairs and wore them more days than not.  Then I got to university and couldn’t stand the way denim felt on me. My favourite jeans sat neglected in my closet until partway through 4th year when suddenly, denim was okay again.  Clothes that haven’t had fabric softener (I use bounce unscented sheets because I’m allergic to a lot of scents and I am a static magnet) drive me around the bend. They are stiff and scratchy and if I have to wear them, I may look like I’m listening but really I’m just counting the hours until I can change.

Flip Flops. Oh my god. I have tried to get into the spirit of summer and don flip flops at the cottage. My record so far is 6 minutes before they were ripped off my feet and tossed aside.  The only thing that goes through my head the entire time I am wearing flip flops is “There is something between my toes.  Why is there something between my toes?  The something between my toes must go away” On a constant loop.  I cannot carry on a conversation in flip flops, I can barely remember my name because I cannot tune out the sensory input coming from the little piece of plastic between my toes. Then there’s the characteristic sound that flip flops make.  It’s distracting enough when it comes from other people, but when I’m the one making it?  I’d stand still except then I still have something between my toes.  I can avoid flip flops but many kids with sensory issues have that level of input coming from everything they wear. Yes some clothes are worse than others, and over time, one can can learn to tune out some of the input but when it’s coming from everything all of the time?  It requires a tremendous amount of energy to do anything after tuning out the sensory distractions.

There are clothing manufacturers out there who make clothes specifically for children and adults with Autism or Sensory Processing Disorder. They feature flat seams that are far less irritating than regular seams, some seamless designs. printed on labels, and soft fabrics.  They are expensive but can be a lifesaver if your child is really struggling.  Some regular clothing stores incorporate some sensory friendly elements in their clothing – Joe Fresh has some clothes with printed labels instead of tags and flat seams. I love Smartknit socks – not only are they seamless but they have no heels so they are easy to put on and fit growing feet for longer.  They also make seamless underwear and undershirts.

With food, it often isn’t the taste that I cannot handle (though occasionally it is – the taste / smell of root beer drives me crazy) but the texture.  Certain food textures are more upsetting than others. I am well aware of how awesome chia seeds are for your health.  I can totally appreciate that adding them to chocolate pudding makes it somewhat healthier, but I cannot handle the texture of chia seeds. You can lie to me and tell me it’s plain pudding but it’s not a preference thing, I will feel the jelly-like seeds on my tongue and, because I was raised to be polite, I will swallow one bite and politely refuse any more.  Many kids can’t force themselves to swallow it.  I do not advocate trying to trick children with sensory issues into eating foods they dislike because they will know, and then they will be suspicious of any new food.  There are therapies, usually provided by an Occupational Therapist, specifically designed to help children whose sensitivity to food texture prevents them from being able to eat a healthy diet, but the majority of sensory kids have texture families they cannot stand but are fine with others.

This doesn’t mean you shouldn’t introduce new foods, but don’t insist on a child with sensory issues swallowing the new food. If you can, ask them why they don’t like it.  Tastes can take time to develop, sometimes it takes a number of reintroductions before one acquires the taste for something. Textures, are another story – aversions to textures are unlikely to change as a result of repeated introductions. That’s not to say they can’t change, but it’s more of an internal change and not something that can be forced.

Another food texture issue that is common is a refusal to try a food in an altered state.  Apples may be a favourite food, but apple crisp makes crunchy apples soft and that isn’t right.  Toasting marshmallows gives the outside a crunchy texture when marshmallows are supposed to be soft.  A child may like mashed potatoes but refuse to eat baked potatoes because the texture isn’t what they expect. Different textures can mean that even if a child likes the food, they cannot tolerate the altered state.  Smoothies can be a tricky sensory combination as some fruits like strawberries have tiny seeds that don’t get fully blended. Smoothies are also a combination of flavours and many kids (and adults) on the spectrum do not like flavours to mix.

Figuring out what the sensory issue is can be a bit like solving a mystery. If a child is non verbal, it can be harder to identify the cause of the problem but not impossible.  You basically need to approach the situation like a detective – is anything new? If so, try reverting back and see if the behaviour stops.  Are there irritating tags? Take them out (use a seam ripper if possible since the stubs left from cutting can be worse than the tag itself). Is their skin dry?  Did you change detergents? Any of these can be the cause.  If the child can nod or give yes / no answers you can ask “is this bothering you” as you hold up different items of clothing. If a food was presented in an altered state (such as soft boiled eggs instead of scrambled), try introducing the food in the expected state and see if the child accepts it.

A child who cannot handle wearing certain clothes, or deal with food textures may react in a way that looks like he is an overindulged brat. Friends and relatives will tell parents that they are spoiling the child by letting them get away with reacting.  There is nothing further from the truth.  We want to set children up for success.  A child is more likely to succeed when they are not being distracted by scratchy clothes and they have been fueled with food that they enjoy and that gives them adequate nutrition.    With a better understanding of sensory issues, it becomes easier to see how what looks like a tantrum is actually a cry for assistance.