Managing Sensory Sensitivities in Autism
By Jennifer KempMost Autistic people have differences in sensory perception that result in sensitivities and insensitivities to certain kinds of sensory experiences. When a person has a sensitivity to sensory experiences, exposure to these can be intensely uncomfortable and highly distressing. Given that everyday experiences involve sensory input across multiple senses, sensitivities can have a profound negative impact on an Autistic person’s life, making it harder to socialise, work and study comfortably. Continual exposure to sensory stressors can worsen mental health and contribute to burnout (Chen et al., 2024). Feeling overwhelmed by sensory sensitivities can lead to understandable attempts to control stressful experiences, which others may misunderstand as “rigid” and “inflexible” behaviour.
Identifying Sensory Stressors
Autistic people can have sensitivities across all eight senses. Here are examples of the kinds of experiences that can be uncomfortable for Autistic young people and adults:
- Sight (Visual): 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 (Olfactory): Strong perfumes or body sprays, cooking smells, cleaning chemicals, odours from new carpet, furniture, or paint, and unpleasant odours in bathrooms.
- Hearing (Auditory): Dogs barking, babies crying, fireworks, thunderstorms, fire alarms, ringing phones, keyboard clicking, the clatter of cutlery and dishes, loud music, the buzz of many people talking, and the persistent humming, buzzing, or whining of ventilation systems, refrigerators, computers, electrical appliances, and fluorescent lights. Specific sensory sensitivities related to the sounds humans make or particular patterns of sound can sometimes be described as misophonia.
- Taste (Gustatory): Unfamiliar or unexpected flavours in foods or preferred products, such as a change in the flavour of toothpaste, or the aftertaste of medications.
- Touch (Tactile): 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 (Vestibular): 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 (Proprioceptive): 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 physical sensations (Interoceptive): 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
Repeated exposure to uncomfortable sensory experiences will not reduce an Autistic person’s sensitivity or alleviate the distress it causes (D’Mello et al., 2023; Guiraud et al., 2011; Jamal et al., 2021). In general, Autistic people do not “habituate” to uncomfortable sensory experiences, and repeated exposure seems to trigger a fight/flight response via the sympathetic nervous system that may be anxiety-provoking and traumatic (Verhulst et al., 2022).
Thus, sensitivities continue to be uncomfortable no matter how much or often a person is exposed to them, and may become more upsetting over time. This is what we mean when we say that Autistic people are “playing life in hard mode.”
Supportive Strategies to Manage Sensory Stress
As therapists and caregivers we 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, developing greater understanding from others, asking for essential accommodations, and teaching helpful tools for recovery (MacLennan et al., 2023). We may also provide direct assistance in overcoming the barriers to essential services caused by sensory stress (Stromberg et al., 2022).
Consider the following strategies:
- Reduce exposure to sensory stressors at home, school, and work by making changes to the environment, such as using lamps instead of overhead lights, avoiding strong perfumes, and offering predictable and safe food choices.
- Provide sensory-soothing 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 regulation skills for experiences where the person is exposed to their triggers, particularly self-soothing strategies such as stimming through repetitive movements, and engaging with calming and pleasant activities.
- Create predictability in everyday life to minimise the likelihood and impact of unexpected stressors, such as creating daily routines and clearly explaining what is about to happen and what to expect.
- Teach self-advocacy skills so that the person can advocate for what they need
- Advocate directly on the person’s behalf by writing letters, making phone calls, and speaking to key caregivers such as parents, teachers, and allied health support
- Provide equipment to reduce sensory stress, such as noise-cancelling headphones, earplugs, sunglasses, and protective clothing.
- Develop communication strategies to help the person express their needs, including non-verbal strategies if the person can become too overwhelmed to speak.
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
