Expert: Dr. Sharon A. Mitchell - 1/1/2010

Question
My 9 year old son was diagnosed as autistic when he was 4 and has sensory issues, however, has only just recently begun holding his arms over his ears to block out sound, even when there seems to be no noise.  Is is possible for him to suddenly become sensitive to noise and what suggestions would you have to deal with it.

I look forward to hearing from you

Answer
Yes, it is possible. The constant for him may be that he has sensory issues, not which sensory issue he has. A child who previously had few tactile issues may become averse to wearing clothes with certain textures or weights. A child who loved going outside to play may begin to tantrum when going outside means wearing a heavy, noisy winter snowsuit. Or a child who used to hate bathing may suddenly relish the feel of warm water on his body.

Sometimes these changes come about when there is something different going on, such as alterations in home life, new demands, being out of routine (such as being away from school for Christmas break) or illness. Are their new stressors in his life? Is he entering puberty?

Kids with autism can feel unwell without showing the typical outward signs. Think of autism as a processing disorder where the person can only process the information from one sensory system at a time. This makes it hard to take regular reading on your body to register its state. There are children with autism who have a difficult time registering when they are hungry or thirsty or cold or hot or tired. Or hurting. They may feel upset but not know why or be able to tell you how they are feeling.

Theory of Mind also comes into play here. People with autism have weak theory of mind skills or mind-reading. They assume that you know what is in their mind, that you know their thoughts and feelings so may not tell you things, assuming that you already know.

Does your son have a cold? The flu? An ear infection? I would suggest that a visit to his doctor would help to rule out any physical cause for his increased hearing sensitivity.

If you have ruled out a physical cause, then look to sensory sensitivities. Since you mention he was diagnosed five years ago and has had sensory issues, then I presume that you have been in contact with an occupational therapist. They are excellent sources of help with difficulties in the sensory realm. An OT who knows your boy would likely have suggestions tailor-made for him.

Since you are familiar with his previous sensory issues, what comforts him? What sensory input has a calming effect for him? Do weights work? Pressure? Vestibular stimulation? Proprioceptive?
There are a couple ways of trying to help. One is through a sensory diet where at regular intervals throughout the day you give him short periods of the type of stimulation his body craves to feel calmer.

The other approach is to provide the needed stimulation at times when you think he may become upset. For example, if his hearing sensitivity is increased in noisy, crowded situations, have him wear a weighted vest when he goes to the mall with you.

Here are some common things that you could try:

•   Swinging
•   Using a rocking chair
•   Playing on a teeter totter
•   Jumping on a trampoline or rebounder (mini-trampoline)
•   Sitting on a therapy ball
•   Rolling a therapy ball over his body
•   Sitting in a bean bag chair
•   Being sandwiched in between two large cushions (or under your couch cushions)
•   Laying under heavy blankets
•   Wearing a weighted vest
•   Wearing a pressure vest (sometimes called bear hug vests – often made of neoprene)
•   Wearing ankle weights
•   Placing a weighted pillow on his lap
•   Playing with fidget toys (scraps of fabric or ribbon, squeeze balls, etc.)
•   Doing push-ups against a wall
•   Carrying or lifting something heavy

These are only general suggestions since I don’t know your son. An OT could observe and do a sensory profile and give suggestions specific to how your son is doing right now.
If you feel he is in an upset state right now, try to make your household as routine as possible. Use a visual schedule to let him know what to expect in his day. This can be especially important during the holiday season when guests are arriving or he may be going to the homes of other people.

www.do2learn.com is a good site if you are unsure how to use a visual schedule, plus there are free pictures available there. Social stories are a good way to let him know what will be expected of him. Here are some examples of social stories:  http://www.autisminspiration.com/public/department47.cfm And here is some information on how to write social stories or your own: http://www.hisd.k12.mi.us/specstuserv/tipsheets/Social%20Stories.pdf

I know that busy mothers of kids with autism do not have a lot of time to read. So, when I recommend books I like to choose short, little ones or books that you can skim the table of contents and only read the parts that pertain to your current situation. Here are a couple I like that you might find helpful:

Social stories - http://www.amazon.com/dp/188547766X?tag=autismhelpf0e-20&camp=14573&creative=327...

Sensory issues - http://www.amazon.com/Asperger-Syndrome-Sensory-Issues-Practical/dp/0967251478/r...

-   http://www.amazon.com/Answers-Questions-Teachers-Sensory-Integration/dp/19325654...

-   http://www.amazon.com/Out-Sync-Child-Has-Revised/dp/0399532714/ref=sr_1_1?ie=UTF...

Please take this next link with caution. I am no expert in medicine but there is some research about dietary deficiencies and increased hearing sensitivity. I would suggest that you talk with your physician or a nutritionist about this if you think it might pertain to your little boy: http://www.ctds.info/noise-sensitivity.html

Best wishes to you and your son,

Sharon A. Mitchell, B.A., B.Ed., M.A., PhD candidate
www.autismsite.ca