It is always important to understand that simply loving your autistic child is not enough, one needs skills and tools to work with, an education to teach them how to cope with situations that arise that are challenging because they begin before you are ready for it and one day they may taper off but they will always be around. So be prepared! Give your child tender loving care, words of praise as often as you can, seek professional help and guidance, never stop having faith in what your child can achieve and his potential or how you can increase the love and compassion in your life through words and actions one small change at a time. Patience is the key, calm, breathing deeply, and living in the moment is something that we all forget about. Oh yes, and seek out support in your community.
Here is something that I found that is not comprehensive but somewhat covers sensory issues with autism and some things that can cause them, and some things that can be done about them. By no means is this professional information, it does not come from a doctor or an Occupational Therapist but it does fit with a lot of the information that I have learned over time with Griffin.
I did have a post of meltdown vs. tantrum but took it down because after reviewing it again I found some issues with it that I disagreed with and found to be untrue, apparently I did not read it well enough the first time....not a good idea if I am going to post something and claim to be a writer.
Utililized information from www.autism.org.uk
This page covers some of the challenging behaviors that children with autism often display. It also gives possible reasons for these behaviors, and suggestions for different ways of dealing with them.
Coping with a child who has an autism spectrum disorder (ASD) can be very difficult; particularly when they display challenging behaviour. It can be even more difficult to cope if your child is non-verbal. Challenging behaviour includes what would typically be considered physically aggressive behaviour, but can also include behaviours like pica (putting inedible items in the mouth) and hand flapping if they are having a negative impact on your child or your family. This information sheet focuses on coping with challenging behaviour and can be used alongside our information sheets on ‘Understanding behaviours’ and ‘Behaviour guidelines.’
It is important to bear in mind that behaviour has a function and that there could be a number of reasons for it. These may include difficulty in processing information, unstructured time, over-sensitivity (hyper) or under-sensitivity (hypo) to something, a change in routine or physical reasons like feeling unwell, tired or hungry. Not being able to communicate these difficulties can lead to anxiety, anger and frustration, and then to an outburst of challenging behaviour.
Dear diary…Some parents have found it very useful to set up a diary to identify behaviour triggers and to see if a pattern emerges. This involves writing down what was happening before the behaviour, the behaviour itself and what happened immediately after it. It is important to note the environment around your child before, during and after the behaviour, including who was there, any change in the environment and how your child was feeling. That way, you will be able to find the cause or the function of the behaviour and try to prevent it from happening in future.
The next section looks at some typically challenging behaviour, the possible reasons for it and some suggested strategies for addressing it.
Pinching, kicking, slapping
- frustration at not being able to communicate
- difficulty waiting for something, because of difficulty with concept of time and abstract thinking
- an unfamiliar person
- a change in routine
- over-sensitivity to noise, crowds, smells, touch, sight (see our information sheet ‘The sensory world of the autism spectrum’)
- under-sensitivity – seeking out sensory input from pinching or slapping
- feeling unwell, tired, hungry, thirsty, uncomfortable
- not wanting to do something.
- use the Picture Exchange Communication System (PECS) and/or visual supports to help with communication and show your child the sequence of events and routine for the day
- prepare for meeting unfamiliar people by showing photographs of them and introducing them in small stages. Tell your child when they will see them, using visual support
- prepare for any changes in routine
- use ear defenders to block out noise and sunglasses to reduce light, and reduce strong smells, replacing them with smells that your child prefers
- create opportunities for sensory stimulation, eg pinching play-dough, clapping hands, singing a clapping song/rhyme, kicking a football or punch bag
- reward your child for doing something they don’t want to do, straight after the desirable behaviour
- say in a calm, monotone voice, without showing emotion: “(Child’s name) hands down/feet down. No pinching, slapping, kicking” and then redirect them.
- feeling unwell or in pain
- reluctant to wipe because toilet paper may be too harsh
- seeking out sensation from texture, smell or movement of arms during smearing action
- attention seeking/wanting a reaction
- not knowing where faeces needs to go
- fear of toilets.
- provide an alternative with the same texture, eg papier-mâché, gelibaf, gloop (cornflour and water), finger painting, play-dough, etc
- make a structured timetable of the day, showing times when your child can do appropriate smearing activities
- take your child to the GP to make sure that there are no physical reasons involved, like being in pain
- if your child does not understand the wiping process, teach them ‘hand over hand’
- if the toilet paper is too harsh for your child’s sensitive skin, wet wipes could be a gentler alternative
- avoid asking your child to clear up after themselves, as they may interpret this as being a reward
- avoid paying too much attention or showing too much reaction
- do not tell them off, as this can be seen as reinforcement of the behaviour
- use minimal interaction and alternative cleaning-up methods, like baby wipes or a tepid shower
- set up a toileting routine (see our ‘Toilet training’ information sheet)
- use ‘all-in-one’ suits (available from the Abena website: www.abena.co.uk).
- enjoys the reaction from an adult or another child around them
- is looking for attention/interaction
- has difficulty swallowing and/or may be producing too much saliva
- likes to play with the saliva and enjoys the way it feels
- uses the behaviour to avoid doing something.
- take your child to the GP and/or dentist to rule out any medical reasons
- avoid making eye contact with your child
- play this behaviour down as much as possible
- limit verbal communication
- wipe away the saliva as soon as it happens
- do not give your child attention
- redirect them to a more appropriate activity
- provide alternative sensory activites, eg water play, finger painting, etc
- give your child lots of positive attention for doing a more appropriate activity
- give them a sweet or something to suck to keep their mouth busy
- make sure they understand what is expected and redirect them to a visual timetable.
- seeking out a reaction from an adult
- looking for attention
- having difficulty meeting new and unfamiliar people
- seeking out or avoiding a sensory input, eg the smell of the person or the noises they make.
- tie long hair back
- avoid giving your child a reaction
- do not talk to them
- do not make eye contact
- distract them by, eg, tickling them or giving positive reinforcement
- redirect them to a more appropriate activity
- prepare your child when introducing them to unfamiliar people
- give opportunities to satisfy the pulling sensation they may enjoy, eg ‘row your boat’ game, tug of war, climbing up a rope, etc.
- looking for attention
- seeking out sensory input to the mouth
- frustration at not being able to communicate something that is causing distress and to get it to stop, or struggling to get needs met
- reacting to something going on in the environment, eg too much noise
- pain in the mouth or teeth.
- rule out any medical or dental reasons for the biting
- improve communication: “(Child’s name), no biting”
- use PECS and visual supports – use a ‘no biting’ symbol and a picture symbol showing what to do instead of biting
- increase structured activities
- reduce noise levels or other sensory stimuli that your child could find upsetting
- provide alternative things to bite, eg chewy tubes (see our ‘Biting’ information sheet)
- look at anger/emotions management and create opportunities for your child to relax
- redirect them to a more appropriate activity
- reward appropriate behaviour, eg “(Child’s name), that’s good sharing with your sister”, and give a reward as soon as you see appropriate behaviour, to encourage it to continue.
- not understanding which items are edible and inedible
- seeking out sensory input – the texture or the taste of the item
- relieving anxiety or stress
- seeking attention
- getting out of doing something.
- replace the inappropriate item with an appropriate alternative of a similar texture, eg a crunchy carrot stick if your child chews on things like stones or sticks
- provide other forms of stimulation for the mouth, eg chewy tubes, popcorn, chewing gum, etc
- set up a sorting activity for your child to sort edible and inedible items
- take your child to the GP to rule out any medical problems or pain in the mouth
- consider any vitamin or mineral deficiencies
- reward your child for putting edible items in their mouth
- use PECS to encourage your child to put appropriate items in their mouth and reward them
- increase the amount of structured activities your child does and distract and divert their attention.
These are just a few examples of behaviours that can be challenging. You can find more examples in our list of frequently asked questions about behaviour.
ConsistencyAlthough these kinds of behaviours can be extremely challenging, it is really important to try and keep as calm as possible so that your child is unable to ‘feed’ off your reaction. It is also important to be consistent in your approach and for the other adults around to use the same consistent approach, so that your child does not get mixed messages and can be really clear about what is expected.
LanguageBy reducing language, your child is less likely to feel overloaded by information and more likely to be able to process what you say. Children with an ASD are often strong visual learners and can have difficulties with short-term memory. It can be very effective to back up what you are saying to your child with visual supports, which consolidate what you say and to help your child really understand the information.
RewardsUsing rewards and motivators can help to persuade your child finish a task that they do not want to do, or to encourage a particular behaviour. Even if the behaviour or task is very short, eg one minute, if it is followed by lots of praise and a reward, the child learns what behaviour is acceptable. But if the undesirable behaviour is met with a lack of attention and redirection, it is likely to stop.
RelaxationIt can be helpful to build in opportunities for children (and parents!) to relax each day. You can do this by, for example, looking at bubble lamps, smelling essential oils, listening to music, massages, swinging on a swing or whatever you can find that seems to help your child relax. Challenging behaviour can often be diffused by an activity that releases energy or pent-up anger or anxiety. This might be punching a punch bag, bouncing on a trampoline or running around the garden, which you can make into a chase game.
Support in the USA through the Autism Society there you can ask questions and find out more about the causes, symptoms, diagnosis, and treatments of autism.
Many people with an autism spectrum disorder (ASD) have difficulty processing everyday sensory information such as sounds, sights and smells. This is usually called having sensory integration difficulties, or sensory sensitivity. It can have a profound effect on a person's life.
Here, we look at:
- how our senses work
- the seven senses in detail
- sensory difficulties that people with an ASD may experience
- ways of dealing with sensory difficulties
- professionals and resources that can help.
How our senses workOur central nervous system (brain) processes all the sensory information we receive and helps us to organise, prioritise and understand the information. We then respond through thoughts, feelings, motor responses (behaviour) or a combination of these.
We have receptors all over our bodies that pick up sensory information, or 'stimuli'. Our hands and feet contain the most receptors. Most of the time, we process sensory information automatically, without needing to think about it much.
People with sensory integration difficulties - including many people with an ASD - have difficulty processing everyday sensory information.
People who struggle to deal with all this information are likely to become stressed or anxious, and possibly feel physical pain. This can result in challenging behaviour.
If I get sensory overload then I just shut down; you get what's known as fragmentation...it's weird, like being tuned into 40 TV channels.
Our seven sensesWe have seven senses:
- balance ('vestibular')
- body awareness ('proprioception').
SightSituated in the retina of the eye and activated by light, our sight helps us to define objects, people, colours, contrast and spatial boundaries. People with an ASD may experience the following differences.
- Objects appear quite dark, or lose some of their features.
- Central vision is blurred but peripheral vision quite sharp.
- A central object is magnified but things on the periphery are blurred.
- Poor depth perception – problems with throwing and catching; clumsiness.
- Distorted vision: objects and bright lights can appear to jump around.
- Images may fragment.
- Easier and more pleasurable to focus on a detail rather than the whole object.
She was Mrs Marek, a face upon which light danced maniacally, turning her into more of a cartoon than a human being. Welcome to Toon town…I'd like you to enter this torture chamber I call my kitchen and meet my wife who is a 3D cartoon. Gillingham, G. (1995), page 51
SoundThis is the most commonly recognised form of sensory impairment. Hearing impairments can affect someone's ability to communicate and possibly also their balance. People with an ASD may experience the following differences.
- May only hear sounds in one ear, the other ear having only partial hearing or none at all.
- May not acknowledge particular sounds.
- Might enjoy crowded, noisy places or bang doors and objects.
- Noise can be magnified and sounds become distorted and muddled.
- Particularly sensitive to sound and can, for example hear conversations in the distance.
- Inability to cut out sounds – notably background noise, which often leads to difficulties concentrating.
Do you hear noise in your head? It pounds and screeches. Like a train rumbling through your ears. Powell, J. (in Gillingham, G. 1995), page 41
TouchTouch is important for social development. It helps us to assess the environment we are in (is an object hot or cold?) and react accordingly. It also allows us to feel pain. People with an ASD may experience the following differences.
- Holds others tightly - needs to do so before there is a sensation of having applied any pressure.
- Has a high pain threshold.
- May self-harm.
- Enjoys heavy objects (eg, weighted blankets) on top of them.
- Touch can be painful and uncomfortable; people may not like to be touched and this can affect their relationships with others.
- Dislikes having anything on hands or feet.
- Difficulties brushing and washing hair because head is sensitive.
- Only likes certain types of clothing or textures.
Every time I am touched it hurts; it feels like fire running through my body. Gillingham, G. (1995), page 3
TasteChemical receptors in the tongue tell us about different tastes - sweet, sour, spicy and so on. People with an ASD may experience the following differences.
- Likes very spicy foods.
- Eats everything - soil, grass, Play-dough. This is known as pica.
- Finds some flavours and foods too strong and overpowering because of very sensitive taste buds. Has a restricted diet.
- Certain textures cause discomfort; some children will only eat smooth foods like mashed potatoes or ice-cream.
SmellChemical receptors in the nose tell us about smells in our immediate environment. Smell is the first sense we rely upon. People with an ASD may experience the following differences.
- Some people have no sense of smell and fail to notice extreme odours (this can include their own body odour).
- Some people may lick things to get a better sense of what they are.
- Smells can be intense and overpowering. This can cause toileting problems.
- Dislikes people with distinctive perfumes, shampoos, etc.
Smells like dogs, cats, deodorant and aftershave lotion are so strong to me I can't stand it, and perfume drives me nuts. Gillingham, G. (1995), page 60
Balance (vestibular)Situated in the inner ear, our vestibular system helps us maintain our balance and posture, and understand where and how fast our bodies are moving. People with an ASD may experience the following differences.
- A need to rock, swing or spin to get some sensory input.
- Difficulties with activities like sport, where we need to control our movements.
- Difficulties stopping quickly or during an activity.
- Car sickness.
- Difficulties with activities where the head is not upright or feet are off the ground.
Body awareness (proprioception)Situated in the muscles and joints, our body awareness system tells us where our bodies are in space, and how different body parts are moving. People with an ASD may experience the following differences.
- Stands too close to others, because they cannot measure their proximity to other people and judge personal space.
- Hard to navigate rooms and avoid obstructions.
- May bump into people.
- Difficulties with fine motor skills: manipulating small objects like buttons or shoe laces.
- Moves whole body to look at something.
SynaesthesiaSynaesthesia is a rare condition which some people with an ASD experience. A sensory experience goes in through one system and out through another. So a person might hear a sound but experience it as a colour. In other words, they will 'hear' the colour blue.
Ways to helpHere are some ways you may be able to help a person with sensory sensitivity. Often, small changes to the environment can make a difference.
Three points to remember are:
- be aware: look at the environment to see if it is creating difficulties for people with an ASD. Can you change anything?
- be creative: think of some positive sensory experiences
- be prepared: tell people with an ASD about possible sensory stimuli they may experience in different environments.
Ways to help: sightHypo (under-sensitive)
- Increase the use of visual supports. (See www.autism.org.uk/visualsupports for more information about using visual supports.)
- Reduce fluorescent lighting - use deep-coloured light bulbs instead.
- Wear sunglasses.
- Create a workstation in the classroom: a space or desk with high walls or divides on both sides to block out visual distractions.
- Use blackout curtains.
Ways to help: soundHypo
- Use visual supports to back up verbal information.
- Shut doors and windows to reduce external sounds.
- Prepare a person before going to noisy or crowded places.
- Wear ear plugs.
- Listen to music.
- Create a workstation.
Ways to help: touchHypo
- Use weighted blankets or sleeping bags.
- Warn a person if you are about to touch him or her; always approach him or her from the front.
- Remember that a hug may be painful rather than comforting.
- Gradually introduce different textures - have a box of materials available.
- Allow a person to complete activities themselves (eg, hair brushing and washing) so that they can do what is comfortable for them.
Ways to help: tasteSome people with an ASD are hyper- or hyposensitive to taste, and may limit themselves to bland foods or crave very strong-tasting food. We have not included any ways to help because as long as someone eats a bit of a varied diet, this isn't necessarily a problem. For more information about ASD and restricted diets however, visit www.autism.org.uk/restricteddiet
Ways to help: smellHypo
- Use strong-smelling products as rewards and to distract people from inappropriate strong-smelling stimuli (like faeces).
- Use unscented detergents or shampoos, avoid wearing perfume, make the environment as fragrance-free as possible.
Ways to help: balanceHypo
- Encourage activities that help to develop the vestibular system. For children this could include using rocking horses, swings, roundabouts and seesaws. For adults, try games like catching a ball or practise walking smoothly up steps or curbs.
- Break down activities into small, more easily manageable steps; use visual cues such as a finish line.
Ways to help: body awarenessHypo
- Position furniture around the edge of a room to make navigation easier.
- Put coloured tape on the floor to indicate boundaries.
- Use the 'arm's-length rule' to judge personal space. This means standing an arm's length away from other people.
- Do 'fine motor' activities like lacing boards (available to buy online).
How sensory sensitivity affects behaviourSometimes, a person with an ASD may behave in a way that you wouldn't immediately link to sensory sensitivities - but they may be the underlying cause. Here are some examples of how a person’s behaviour may result from sensory sensitivities, and how you can help.
Problem: picky eater
- Possible reasons: sensitive to taste or texture, or unable to feel food around the mouth.
- Possible solutions: change the texture of food, for example purée it. Slowly introduce different textures around the person's mouth, such as a flannel, a toothbrush and some different foods. Encourage activities that involve the mouth, such as whistles or bubble wands.
- Possible reasons: may find this relaxing, or enjoy the sensation of chewing on the item.
- Possible solutions: offer latex-free tubes, straws or hard sweets (chill in the fridge).
- Possible reasons: may like the texture of feces or not be very sensitive to smells.
- Possible solutions: try and introduce things like jelly, or cornflour and water to handle instead; introduce alternative strong-smelling items.
- Possible reasons: may dislike the texture or pressure of clothes on their skin.
- Possible solutions: turn clothes inside out so there is no seam, remove any tags or labels, allow the person to wear clothes they're comfortable in.
- Possible reasons: may have difficulty shutting down their senses, in particular sight and hearing.
- Possible solutions: use blackout curtains or weighted blankets; listen to music to cut out external sounds.
- Possible reasons: too many distractions like noise (talking, bells, chairs scraping the floor) or visual stimuli (people, pictures on the wall). May also find holding a pencil uncomfortable (it may feel hard or cold).
- Possible solutions: position child away from doors and windows so there are fewer distractions. If possible use an individual workstation with some screens around it; or use classroom furniture to create a distraction-free area for the child. Try different textures to make the pencil more comfortable.
Professionals who can helpOccupational therapists design programmes and often make changes to the environment so that people with sensory difficulties can live as independently as possible.
Speech and language therapists often use sensory stimuli to encourage and support the development of language and interaction.
Music therapists use instruments and sounds to develop people's sensory systems, usually their auditory (hearing) systems.
Sensory roomsSensory rooms can help to stimulate, develop or balance people's sensory systems. Some specialist schools, local services and hospitals have them, as well as some nurseries. You may also come across sensory gardens. Some families create a sensory room in their house (or adapt a corner of a room, perhaps screening it off with a curtain).
Sensory rooms might include:
- soothing music
- vibrating cushions
- fibre optics
- mirror balls
- bubble tubes
- water beds
- tactile walls
- disco lights
- equipment that is activated by switches, movement, sound or pressure so that people learn about cause and effect.
It is always best to consult a professional Occupational Therapist for help in these areas for advice and ongoing skills to use daily, there are great catalogs out there with equipment that is useful for sensory issues.
Griffin mostly uses the yoga ball for both calming and energizing himself in different positions and he jumps on the mini trampoline that my parents got for him years ago that he has really worn out, he loves to swim and dance when no one is looking. LOL!