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Treatments needed for severe sensory sensitivity

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Temple Grandin
25 October 2011

Sensory overload: Some children with autism love to push the cart in the grocery store, but others cannot stand the loud noises and flickering lights. 

One of the most debilitating symptoms for some children and adults with autism is sensory oversensitivity, for example to loud noises or fluorescent lights. These oversensitivities make it impossible for a child or adult with the disorder to participate in normal activities, but there is little research on this topic. 

I have talked to many parents who cannot go shopping with their child with autism. Every trip to the supermarket results in screaming and tantrums. When I was a child, loud noises hurt my ears like a dentist’s drill hitting a nerve.

Today, sensitivity to loud noise is just a nuisance for me. Unfortunately, there are some individuals who are never able to do normal activities such as going on a train or shopping in a crowded, noisy supermarket. For example, a study published earlier this year showed that sensory-related behavior limits participation in work, family and leisure activities1.

There are some reactions to sensory overstimulation that could be confused with social deficits. Some individuals react to sensory overload by screaming, but others may withdraw. This withdrawal could be confused with having social deficits.

Specific sensitivities:

One of the factors that makes this aspect of autism difficult to study, however, is that sensory problems are variable. One child with autism might scream every time he or she goes to the supermarket, whereas another child might love to go to the supermarket and push the cart.

A big problem with many autism studies is that the children are often categorized solely based on whether they have autism, with no assessment of their sensory problems. This sort of research would be more effective if participants were assigned to a treatment group whose members have autism, but also have a specific sensory sensitivity. 

For example, the study would include only children who have autism and cannot tolerate loud noise. Children with autism who can easily tolerate loud noise would not be included.

There is another subgroup of individuals with autism who absolutely cannot tolerate fluorescent lights. They can see the 60 Hz flicker and the entire room becomes a flashing strobe light. A study on problems with fluorescent lights should include only those individuals with autism who have difficulty tolerating the lights. 

Another factor that has an effect on sensory sensitivity is fatigue. When an individual on the spectrum is tired, sensory sensitivity worsens.

For a research study to be effective, the children or adults in the study must also be assigned to treatment based on the severity of their sensory sensitivity.

A search of the PubMed database reveals studies that clearly document that sensory oversensitivity exists. The problem is a lack of studies on effective treatments. I believe that research on treatments for specific problems with oversensitivity should be a top priority.

This research could lead to more effective treatments for alleviating sensory oversensitivity. It would be easier for an individual with autism to participate in normal activities if his or her sensory problems were effectively treated. 

Temple Grandin is professor of animal science at Colorado State University and a best-selling author of books on autism and animal behavior. 

References:

1: Schaaf R.C. et al. Autism 15, 373-389 (2011) PubMed

Comments

Name: usethebrainsgodgiveyou
25 October 2011 - 3:37PM

Dr. Grandin: In 1996, when my son was first diagnosed, there was a stronger link in the literature to sensory problems...then it became all about behaviorism.

Based on advice you gave in "Thinking in Pictures", I did some AIT training at home. Before doing so, he was given testing by a Speech Pathologist. His hearing, at the 2000 hertz range was acute ( 10 x normal)...the sound of a high pitched woman's voice. He used to scream and try to get away when my mother or sister would try to talk to him. They had high, very soft voices and I could never understand why he would attempt to get away. After the testing, I understood.

AIT gave him more tolerance of women's (teachers) voices, and improved his behavior at school. Some teachers voices just drove him away.

How much "behavior" is based on lack of sensitivity to the child's/person's tolerances?

Name: Steve
26 October 2011 - 2:07AM

I have been doing Neurofeedback therapy and getting great results.I'm not paralyzed by hypersensitivity ,but sounds ,lights etc. can fatigue me and cause difficulty with paying attention.The treatments haven't eliminated the symptoms,but have decreased the problem significantly.

Name: Shree Vaidya.
27 October 2011 - 3:23AM

I know a son of my relative whose eyesight is very weak.He gets irritated due to this. That means his behavior is different from other normal child.The treatment did not improve his eye-sight so much.Now, one may come into the conclusion is that any part of the body abnormality = Abnormality in behaviour also.Hence, how to prevent the the cause of abnormality is a big question and a big challenge.

Name: Shanti
14 April 2012 - 10:51AM

I have sensitivity to fluorescent lights, cannot stand loud sounds and sensory issues are worse when fatigued. Actually must look into the last one. My sensitivity is increased when I have hyperactive symptoms, and not as troubling when I have a lack of energy but I think my brain is doing all it can to block out sensory stimuli by making me under aroused. I don't know but when I have more energy it's when I have greater sensitivity.
Paralysing is a good word for my reaction. The medication I'm on can delay it but I also need supports like sunglasses and iPod music when in supermarkets. I have tactile sensitivity which isn't always as severe.
As a child I loved to push the cart in the grocery store but as an adult I have to get in and out as fast as I can, with dark glasses and ear phones in, and I still manage to get sensory overload. I don't know how I can go from one extreme to another.

Name: Matt
29 August 2013 - 8:49PM

I am an Occupational Therapist currently studying Neurofeedback. I am very interested in getting in touch with Steve who left the comment above about his progress with NFB for his hypersensitivity.
Matt

Name: Autistic Strategies Network
13 October 2014 - 10:14AM

Existing research points to the problem as being related to hypokalaemia, exacerbated by high cortisol levels. A potassium channelopathy is typically present, and magnesaemia is usually a factor. Metabolic issues such as histamine intolerance, resulting from methylation problems, limit the benefits of simple treatments, and gut issues, if present, result in poor uptake of electrolytes. Oxidative stress and inflammation also play a role. In spite of these complexities, our self-experimentation using specific dietary changes and electrolyte supplementation has yielded vastly improved sensory tolerance. Based on these self-reports, the University of Cape Town's Department of Neuroscience has agreed to do post-graduate studies on the prevention and treatment of sensory overload, commencing in 2015. We would welcome research partnerships, provided that there is no conflict with the values of our key stakeholders. We recommend that prospective partners contact Fluxes.net or the Autistic Strategies Network.

Name: Autistic Strategies Network
13 October 2014 - 12:06PM

Addendum: Channelopathic hypokalaemia will not be detectable by means of a blood test, because the problem is at cellular level. The potassium level in the blood may appear normal.

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