Supporting Recovery from Sensory Stress
By Jennifer KempMost Autistic people have differences in sensory perception that result in a profile of specific sensitivities and insensitivities across all the senses. Experiences that can be uncomfortable and stressful include:
- Sight: Fluorescent or LED lighting, flashing lights, fireworks, specific colours or patterns, visual clutter in the home, supermarkets, shopping centres, or at public events, and the movement of people in a crowd.
- Smell: Strong perfumes or body sprays, cooking smells, cleaning chemicals, odours from new carpet, furniture, or paint, and unpleasant odours in bathrooms.
- Hearing: Dogs barking, babies crying, fireworks, thunderstorms, alarms, phones, keyboard clicking, loud music, the hum of people talking, and the persistent buzzing or whining of air conditioning, refrigerators, computers, electrical appliances, and fluorescent lights.
- Taste: Unfamiliar or unexpected flavours in foods or preferred products, such as a change in the flavour of toothpaste, or the aftertaste of medications.
- Touch: Sticky, dusty, dirty, or sandy surfaces, itchy, prickly or synthetic fabrics, tight collars, clothing that sits uncomfortably on the body, tight shoes and/or socks, sweating, the feeling of wind or a fan blowing air onto the body, and unexpected touch from others, such as handshakes, pats on the back, hugs, or bumping into people in crowds.
- Balance: Escalators or moving sidewalks, driving or riding in a vehicle that involves frequent stopping, sharp turns, or sudden acceleration, being on a boat, using virtual reality (VR) equipment, walking on uneven, springy, or unstable floors, footpaths, bridges, or boardwalks.
- Movement: Being forced to sit still, in an uncomfortable chair, or with both feet on the floor, bumping into people or objects in a crowded or cluttered environment.
- Internal sensations (interoception): Sudden increases in heart rate, sweating, being too hot or cold, needing to urinate/defecate, hunger, pain in joints, muscles or organs, nasal congestion, fatigue, or itchiness.
Understanding the Ongoing Impact of Sensory Sensitivities
When a person is sensitive to sensory experiences, exposure to them can be intensely uncomfortable and highly distressing. This can have a profound negative impact on an Autistic person’s life, making it harder to socialise, work and study comfortably, and leading to understandable attempts to control stressful experiences, which others may misunderstand as “rigid” and “inflexible” behaviour. Continued exposure can affect mental health and contribute to burnout (Chen et al., 2024).
Uncomfortable sensory experiences do not get any easier or more comfortable over time. Repeated exposure can trigger a fight/flight response, be anxiety-provoking, and even traumatic (D’Mello et al., 2023; Guiraud et al., 2011; Jamal et al., 2021; Verhulst et al., 2022). This is what we mean when we say that Autistic people are often “playing life in hard mode.”
Supportive Strategies to Manage Sensory Stress
Therapists and caregivers can help Autistic young people and adults with sensory sensitivities to recover, regulate and reconnect (Neville et al., 2024) by:
- Reducing their exposure to sensory stressors
- Creating space for recovery
- Providing predictability in daily life
- Advocating for essential accommodations
- Teaching helpful tools for recovery
- Helping the person to overcome barriers to essential services caused by sensory stress
Strategies to avoid sensory stress and support recovery include:
- Make changes to the physical environment, such as using lamps instead of overhead lights, avoiding strong perfumes, and offering predictable and safe food choices.
- Provide low sensory environments to support recovery, such as access to a quiet and dark room, and give explicit encouragement to use them when needed.
- Create opportunities for time alone during which the person can recover and recharge after stressful events.
- Develop emotional recovery skills such as stimming, repetitive movements, and engaging with calming and pleasant activities.
- Create predictability by creating daily routines and clearly explaining what is about to happen and what to expect.
- Teach self-advocacy skills so they can ask for what they need.
- Advocate by writing emails, making phone calls, and speaking directly to key caregivers.
- Provide equipment to defend against stressors such as noise-cancelling headphones, earplugs, sunglasses, and protective clothing.
- Provide alternative communication options including non-verbal strategies if the person can become too overwhelmed to speak.
Of course, there will always be some situations where avoiding sensory stressors isn’t possible. There will also be situations where there it’s necessary to put up with these experiences because the activity is too important or meaningful to miss. In these situations, the key is to allow plenty of uninterrupted recovery time, and access to quiet spaces.
References:
Chen, Y., Jenkins, C. A., Charlton, R. A., Happé, F., Mandy, W., & Stewart, G. R. (2024). “Utterly overwhelming”—A mixed-methods exploration of sensory processing differences and mental health experiences in middle-aged and older Autistic adults. Autism in Adulthood, 1–13. https://doi.org/10.1089/aut.2024.0031
D’Mello, A. M., Frosch, I. R., Meisler, S. L., Grotzinger, H., Perrachione, T. K., & Gabrieli, J. D. E. (2023). Diminished repetition suppression reveals selective and systems-level face processing differences in ASD. The Journal of Neuroscience, 43(11), 1952–1962. https://doi.org/10.1523/jneurosci.0608-22.2023
Guiraud, J. A., Kushnerenko, E., Tomalski, P., Davies, K., Ribeiro, H., & Johnson, M. H. (2011). Differential habituation to repeated sounds in infants at high risk for autism. NeuroReport, 22(16), 845–849. https://doi.org/10.1097/WNR.0b013e32834c0bec
Jamal, W., Cardinaux, A., Haskins, A. J., Kjelgaard, M., & Sinha, P. (2021). Reduced sensory habituation in autism and its correlation with behavioural measures. Journal of Autism and Developmental Disorders, 51(9), 3153–3164. https://doi.org/10.1007/s10803-020-04780-1
MacLennan, K., Woolley, C., Andsensory, E., Heasman, B., Starns, J., George, B., & Manning, C. (2023). “It is a big spider web of things”: Sensory experiences of Autistic adults in public spaces. Autism in Adulthood, 5(4), 411–422. https://doi.org/10.1089/aut.2022.0024
Neville, F., Sedgewick, F., McClean, S., White, J., & Bray, I. (2024). Reacting, retreating, regulating, and reconnecting: How Autistic adults in the United Kingdom use time alone for well-being. Autism in Adulthood, 0(0), null. https://doi.org/10.1089/aut.2024.0148
Stromberg, M., Liman, L., Bang, P., & Igelstrom, K. (2022). Experiences of sensory overload and communication barriers by Autistic adults in health care settings. Autism in Adulthood, 4(1), 66–75. https://doi.org/10.1089/aut.2020.0074
Verhulst, I., MacLennan, K., Haffey, A., & Tavassoli, T. (2022). The perceived causal relations between sensory reactivity differences and anxiety symptoms in Autistic adults. Autism in Adulthood, 4(3), 183–192. https://doi.org/10.1089/aut.2022.0018
