In Part 1, I covered some theories on how autism works. In Part 2 I covered some techniques for managing the core traits of autism. This last part is going to cover two of the most common co-morbidities of autism. SPD and APD.
APD or CAPD is Central Auditory Processing Disorder. It’s a problem that the brain has with processing sound. This usually manifests as a child who passes hearing tests and responds to some noises, but often can’t hear you talking or seems to ignore instructions. This seems to be most common with speech noises. Stress, background noise and being distracted by something can also make it harder to process sound. Imagine someone’s talking to you but in a language you’ve never heard before. You can’t arrange the sounds into words in your head. Sometimes it just takes a little while before the sounds turn into words, sometimes I just don’t get it.
Managing APD is just a case of being ready to calmly repeat things your child has missed. Let them know it’s OK to ask for repetition, and repeat clearly and patiently. It might take a couple of tries. If that doesn’t work, grab your backup communication and clarify. Be sensitive to your child, if they’re getting frustrated or bored, they’re less likely to succeed in processing what you’re saying.
SPD, or sensory processing disorder, is the condition that produces a lot of stereotypical autistic traits. Stimming, tactile defensiveness, sensory seeking. Everything comes back to a difference in the way that (some) autistic people process sensory input. The best theory I’ve come across so far in terms of understanding sensory issues is Sensory Diet.
All human beings, and many different kinds of animals, depend on sensory input to keep their brains active. Stimming can be observed in pets, lab animals, almost any creature that’s not getting the stimulation they need from their environment. We all have a set of senses, we have the classical five: touch, sound, smell, taste, sound, and among others we also have:
- vestibular – the inner ear sense that tells us about how we’re moving and which way is up.
- interoceptive – the sense that tells us what our internal organs are doing, feelings like hunger and thirst
- proprioceptive – the stretch and pressure reception in our joints
For most people, daily activities like walking, driving and sitting provide enough input for all of the senses to keep their brains working well. The autistic brain, however, can have unusually low or high sensitivity to particular senses, making getting the right balance of sensory input quite difficult.
Too much input, or the wrong kind of input, can cause discomfort and meltdowns. Sensory sensitivities vary widely from person to person, but there are a few that pop up frequently when I ask people about theirs:
- Biting tinfoil
- Biting cloth
- Mint flavour, especially toothpaste (the feeling, it stings and burns)
- Strong perfume
- Mint fragrance
- Fingernails bending
- Dry, rough skin
- Synthetic fur/fleece
- Pebbles moving over each other
- Sandpaper/nail files
- Bright light
- Crinkly wrappers
- Shrieking or screaming
- Smashes or clatters
- Busy/overcrowded areas
- Scratchy or tickly fabrics
Your child will probably have their own unique set of aversions. All we can really do is keep them in mind and try to avoid them. Some of these will be food aversions, and while this is very frustrating, as long as your child is getting a nutritionally complete diet there’s no need to force them to eat food they don’t like. Don’t be afraid to see your child’s doctor if you have any concern that your child isn’t getting the right nutrition. It’s important to understand that aversions are different to picky eating. A child who is just fussy can usually eat a food they don’t like if they have to. A child who has an aversion to a specific food will do anything to avoid eating that food, might want to spit out the food, struggle to swallow, or retch and heave after eating it. Offer a good variety of foods and take note of any patterns you notice in aversions. Perhaps your child dislikes salty food, or food of a specific texture or colour, in which case serving it in a different way or choosing a different colour can work wonders.
Your child will probably also go through phases of wanting to eat certain foods to excess. This is because the taste or texture of a certain food satisfies some of their sensory needs. Again, as long as they’re getting the right nutrition and they’re not over-eating, there’s no reason to worry. It’s worth looking for healthier alternatives if your child’s consuming too many calories in a day, or if your child has allergies that need to be accounted for. Again, remember any patterns of colour, texture or flavour that might help to make switches.
As I mentioned in Part 2, stimming is your child’s way of trying to get the sensory input that they need to keep their brain regulated. Children, and even autistic adults, don’t always know before they’re near meltdowns that they have a sensory need. Learning the early signs of different sensory needs is key to managing them in day to day life.
The good news is that there are lots of toys and devices to help with sensory issues. I’ve previously posted about my own survival kit, but there are a few other devices that might be helpful.
- Weighted vests – like a fishing vest with pockets for small weights, helps with pressure needs when out and about.
- Stim toys – putty, stim jewelry, tangle toys.
- Comfortable clothing – check out Tactile Defensiveness by Musings of an Aspie for an insight into clothing choices.
Another good place to look for ideas for managing sensory needs is Sensory Smarts. It lists lots of ideas for different activities that can help to manage different sensory needs. Again, it’s likely to be a case of trial and error. Some activities may really not work for your kid, for example sand in shaving foam would trigger my tactile sensitivities in really unpleasant ways. Avoid any activities your child doesn’t enjoy, sensory management should be fun!
Even with the best sensory management in the world, all the toys and aids, and all of the communication, meltdowns and other problems are going to happen from time to time. Amazing Adventures blogger Michelle Sutton blogs extensively on positive ways to manage difficult behaviours, perform therapy and advocate for your autistic child.