Did you know that most, if not all, autistic people have sensory processing differences and that many have some combination of hyper-reactivity and hypo-reactivity to different types of sensory stimuli? In this episode, I talk about sensory processing differences and how they could be THE core feature of autism.
Topics discussed also include:
If you'd like to know more about topics discussed in this episode, check out:
"The Impact of Atypical Sensory Processing on Adaptive Functioning Within and Beyond Autism" by Neufeld et al.
"Sensory Processing in Autism: A Review of Neurophysiologic Findings" by Marco et al.
Episode intro and outro music: "Outer Space" by Maarten Schellekens (no changes or modifications were made)
The Other Autism theme music: "Everything Feels New" by Evgeny Bardyuzha.
All episodes written and produced by Kristen Hovet.
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Today we're talking about sensory processing differences and autism.
So most autistic people have sensory processing differences which underlie hyper or hypo reactivity to sensory stimuli. In other words, autistic people have an over response or under response to stimuli. Many have some kind of combination depending on the stimuli, they might be hyper reactive to touch, for example, they might be hyper reactive to texture of clothing, or texture of foods. So they might, you know, have to cut out tags and clothes or turn their socks inside out because they can't stand the feeling of the seam on their toes. Or they avoid certain textures like, you know, slimy foods or really crunchy foods, or maybe they really like crunchy foods, or they're hypo reactive in other ways. So maybe it takes a lot of bright light to bother them or to even register.
Sensory differences are often quite distressing, especially the hyper reactive variety, and some autistic people describe certain stimuli as painful. In other words, the stimuli can become strong enough that the feeling is painful. And it goes beyond just simple annoyance, or irritability with the stimuli and it actually goes into pain. If the stimuli is strong enough and distressing enough, the person might injure themselves or become aggressive with others, most especially when they're unable to communicate their distress. Or if they're in an environment where it's unsafe to communicate their distress or where they've been made to feel that communicating this distress is unwanted or unacceptable somehow. I know for a lot of autistic people they're not super aware of when they're becoming overwhelmed with sensory stimuli. So it might sneak up on them, and then they all of a sudden react. For some, it looks like tantrum behavior. So like a meltdown, or it can be a shutdown. For some it's like needing to go into a dark room, or be totally by themselves and just tune everything out. And sometimes the awareness of why this is happening is not happening in real time. So that can create a lot of difficulties with others when we're not able to communicate our needs or communicate even what's going on. It can be challenging for neurological differences that we are not able to control.
Well, sensory processing differences are not unique to autism. They are far more prevalent in autism than in any other neurodevelopmental condition. Signs of sensory processing differences include irritability, anxiety, temper tantrums, as I've mentioned, though, I really dislike that word, tantrum, because it's quite juvenile, it's basically just like a huge emotional response, social isolation or withdrawing from others and from social events, unpredictable behavior that sort of goes with what I was mentioning above, rigidity, inattentiveness, being easily distracted, slow processing time, trouble following instructions, and so on. In some cases, this can look like the person not responding in real time. So maybe you know, something happens and the autistic person will not appear to be responding. This can be a sign of just total overwhelm to other people, it can look like nothing's happening or they're just sitting there. But inside, a lot is going on. And there's like a bottleneck of information. And it's really difficult to respond in real time to respond to things that are happening. But believe me, things are happening in the brain, it just might take a few extra minutes or even hours to get the response out.
Differences in sensory processing are known to be the earliest signs of autism, observed as early as six months of age in those who are later diagnosed as autistic. Many autistic people perceive their sensory differences as the true core of their condition. Sensory differences are also common in other neurodevelopmental conditions, such as in Attention Deficit Hyperactivity Disorder, or ADHD. There's often a combination of hypo and hyper responsiveness to sensory stimuli in the same person. And this can change with time or is dependent on other factors. So again, this could be related to sleep, related to what else is going on in their lives. This could just be related to things that we don't understand yet and just fluctuations in the individual.
Research has shown a high correlation between severity of sensory differences and severity of so called Autism symptoms or traits, such as social challenges and anxiety, indicating that sensory features underlie general adaptive functioning in autism. In other words, it may look like social challenges or social awkwardness or social inability to neurotypicals, but is in fact a person being overwhelmed by sensations and various sensory stimuli. Anyone similarly overwhelmed would behave the exact same way, even if they're not autistic. It just happens a lot more quickly for us, and it takes a lot more for neurotypicals to reach that overwhelmed state.
Adaptive functioning challenges are not fully accounted for by cognitive or intellectual ability. Even challenges with eating and getting dressed or bathing are likely most related to avoiding particular sensations. Though these have been attributed to other issues in past research, such as the person not knowing how to do something, being unable to, etcetera; or an autistic person who doesn't want to interact with others was assumed to be egocentric or antisocial or just not interested in other people, when in fact, they might simply be avoiding sensory overwhelm. And maybe what started off in childhood, like very early on this sort of pattern of avoiding becoming sensorily overwhelmed, became just like a behavior pattern, just something that they do. And then that took away from their social experiences, and lead to a very strong behavior. And then that's referred to as a common core trait in autism when, in fact, it's related to senses and sensory processing differences.
Hyper responsiveness can impact sleep, school activities, mealtime, participation in leisure activities, and self care skills, among others. Not all autistic people have challenges in all of these areas. These are just some of the common ones. Sensation avoiding may lead to withdrawing from sensory rich social situations, thus reducing a person's opportunities to engage and interact with others and develop age appropriate adaptive functioning skills.
Sensory seeking behaviors include when a person intentionally seeks out sensory input, through smell, touch, taste, sight, or sound, and can also include movement. These experiences can be soothing or helpful, but could hurt the person or be troubling to them or others. Often, these are attempts to calm an overactive or overly aroused nervous system and can be a way of seeking body feedback that the person craves.
You may have heard of the word stimming. This refers to self stimulating behaviors, which usually involve repetitive movements or sound making. Stimming or repetitive behaviors or movements are considered core features of being autistic. So everyone stims in some way, whether autistic or not, it's just that this is a core feature for autistic people and is very likely displayed much more often in an autistic person than a non autistic person. Stimming can include biting your nails, twirling your hair, tapping on something, playing with jewelry, even things like humming or singing. It can also include rocking back and forth, twirling or flapping your hands.
It's often thought that stimming is a self regulatory behavior, it's self soothing, it helps reset the nervous system. However, it can be problematic if it leads to injury, or if it's taking away from some other aspect of life. Let's say the person is so overwhelmed that they spend a lot of time stimming. And that might take away from other activities or goals that they want to accomplish. For those reasons, it can be necessary to try to change the stimming behavior or regulate it in some way. But this is very dependent on the person. And it's very different from one autistic person to the next. In my opinion, if a person is stimming a lot, it's usually a sign that something is causing anxiety or fear or discomfort or frustration. And so the environment needs to be looked at. What's going on in the environment that's leading to the stimming? Instead of just trying to like regulate or stop the stimming, try to focus on problems that are leading to that behavior. Maybe too much is going on in the person's environment at home, maybe there's too much noise, too much commotion, too much is being asked of the person, something like that. It often goes back to sensory overload, sensory overwhelm.
What's maybe a bit counterintuitive, is that a lot of autistic people have sensory seeking behaviors, even when they're otherwise hyper responsive to a certain sensation or type of sensation. For myself, I have sensory seeking behaviors most prominently in the areas of sight, sound and movement or proprioception. So for one, I'm super visual. I love looking at sparkly or spinning things or beautiful things. As a child, I would stare at things with sparkles or things like spinning records, specifically watching the needle on the record player, as a record played, the record would slightly wobble. And I would see the needle slowly moving on the record. And it's just very mesmerizing and very calming. As an adult, this has mainly turned into sort of obsessively taking photos and videos and playing these back to myself or recently with social media, posting some to Instagram, or sharing them privately with family and friends. I also get a huge kick out of like changing filter options, messing with brightness and things like that. I can spend a lot of time doing that whether or not I end up doing anything with the actual photo or video. It's just something about watching the changes visually to the image that is just incredibly like soothing somehow. At the same time I detest certain visual stimuli, such as certain types of light, especially, I cannot stand fluorescent light, and it's everywhere. It's in workplaces. It's in stores, and it drives me crazy. I also have trouble holding eye contact. The feeling is like being sucked into a black hole or what I imagine that sensation to be. I love people's eyes and I can make eye contact. But it's just that aspect of holding it or keeping eye contact that's problematic for me if forced to hold it. That will become my sole preoccupation, and all attention to anything else goes out the window. In other words, I can't focus on anything except for eyes, eyes, eyes, eyes. Also one of my main sensitivities is loud or persistent or erratic sounds such as leaf blowers or traffic. I can't handle many people talking at once or even interactions with large crowds in specifically noisy environments. I think it's just too much and I can't hear everyone so like, lines get crossed in my brain and it makes me a bit punchy. Oddly, I crave loud sounds that I find pleasant, such as music. I particularly crave loud bass sounds or instrument sounds where I can feel the sound in my body. I love going to concerts, for example, where I can feel the sound in my whole body.
As a teenager I'd sometimes listen to music too loud in my headphones and then get headaches but the effect was soothing in other ways and seemed to regulate my nervous system. As an adult, I still love and crave concerts and other live music events. But I find that it takes days to recuperate from these events. It's like I get a lot from them, but the next day I'll be in head to toe pain. In terms of movement, I crave daily movement, particularly stretching movements like yoga, but I have to be careful because I also have a connective tissue disorder called hypermobile Ehlers Danlos. So I can hurt my joints pretty easily. But I do crave stretching and different movements. And then I crave difficult cardio activities such as high intensity interval training. I can't go a day without having some form of movement. The more stressed out I'm feeling or overwhelmed, the more I just want to move and jump and get my cardio going. The effects of this craving or sensation seeking are actually good in this area, because it means I'm pretty physically fit and active. But the downside is that I can overdo it and wear myself out where I start getting sick a lot or I start, you know, injuring myself because of just like wear and tear. So it's a constant balancing act that takes a lot of effort and mindfulness on my part.
In summary, a lot of the research is showing that sensory processing differences are so core to autism, that autism might be a sensory processing disorder at its core. And all of the other so called, I hate the word symptoms when it comes to autism, but symptoms and traits of autism are likely related to root sensory processing differences that then create or cause all of these other things that people see in the way of external behaviors. This actually becomes concerning when you think of treatments that a lot of autistic children get to reduce their autistic traits. It's not often formulated that way, but when you look at what the treatment is doing, it's really trying to squelch or control or reduce certain autistic behaviors. So in effect, it's going against the root cause, which is being sensorily overwhelmed. So maybe the main focus should be on environmental changes, changes to the particular person's environment, specifically, because each autistic person is so different in what bothers them and what is overwhelming to them. And then also, what is pleasant to them, everyone's going to have a different sensory profile. So it's really working with the individual differences and the individual person and not trying to control or reduce autistic traits, but make life more comfortable for the autistic person. And make it so that we don't have to spend so much time trying to self regulate in a world that is really not made for us in a lot of ways. It's too loud. It's too cacophonous. I don't know, it's just too much for a lot of people.
But the other thing I want to mention is that it could one day be possible, because the experts and researchers are able to see some of the brain differences that underlie these sensory processing differences, to kind of like make changes in the brain somehow, to basically reduce these differences. But my concern is like the sensory processing differences are also the root cause of a lot of beneficial ways that I see the world. My attention to detail. A lot of things in the world are overwhelmingly beautiful to me, and in ways that I don't think is shared with everyone. And I don't think I would want to give that up, I'd maybe want to take the edge off or have a way to self regulate quickly when I'm feeling overwhelmed or bombarded by sensory input or sensory stimuli, but in such a way that it's not going to get rid of the core autistic traits that I actually love and that I'm grateful for.
So before I say goodbye, I just want to note that I'll be taking a couple of weeks away from the podcast, but we'll return the second week of October. So you can expect another episode then. That's all I have for you today.
Thank you so much for being here.
Until next time, bye.