Expert: Dr. Sharon A. Mitchell - 3/27/2007

Question
My 8 year old daughter has been diagnosed with Asbergers and suffers extremely from certain noises.  One is my husbands clearing his throat. He really can't help it-his sinuses are bad and when my daughter hears this noise she cries and yells "Noises, Daddy"!  She also can't handle her sisters eating by her.  Their chewing and noises I can't even hear bother Chloe.  This problem is making our home really not a peaceful place to be and I don't know what to do.  Chloe tries to be as far as possible away from my husband which I knows hurts him also.  I want to try headphones and I have searching everywhere to get some without music and that are not super expensive but I cannot find any.  PLEASE HELP!  We have tried some earplugs but they are uncomfortable, fall out and when they are in do not work at all!  I would really appreciate your help.  Thanks!

Answer
The sensory sensitivities that plague some kids with Asperger's and other autism spectrum disorders can have a major impact on a child's home and school life. For those of us watching, it can be hard to understand what it would be like to have supersensitive hearing.

But whether or not we understand it, it's real to that person. There are some things you can try to help your daughter.

You mention that you've tried ear plugs but they fall out. Would you consider trying some other kinds? Some of the earplugs you'll find in drug stores are made for adults so their size can be uncomfortable for children, in particular, some of the hard plastic ones designed to keep water out of your ear when swimming.

But you could try some of the small, soft foam or silastic ones. Some are drum-shaped and small look like miniature mushrooms. You squish them between your fingers then insert them into the ear where they expand.

An advantage of these is that they are relatively cheap so you won't feel badly about replacing them frequently. There will then be less concern about risking the possibility of infections with bacteria build-up. Another advantage of these plugs is that while they block out some sounds (like high frequency sounds) they still allow speech sounds, making conversation possible.

Similar in size, but softer are ear plugs that are similar to plastic-encased batting. A brand I like is called "Quiet Down". They are slightly more expensive than their foam counterparts and block out more sound. It would be harder to talk with your daughter if she wore them but not impossible.

Another reason I like these small earplugs is that they are not that noticeable. When out in public you and your daughter may be more comfortable if you are not giving her something that "makes her look different".

If looking cool is important to Chloe then she might like to wear the ear buds that come with Ipods or MP3 players. Even when not connected to a music player, they will still look like something a kid would wear.

If Chloe cannot wear something in her ear, then there are many kinds of larger headphones to try. Some will cost hundreds of dollars, some can be had for less than ten dollars. Remember the older kinds of headphones we used to have with stereo sets. When they wore out, some people hung on to them even though they no longer worked. If you just want them to mask sounds, you might be able to find some among your friends or at your daughter's school.

The following website offers a wide variety of ear plugs and ear protectors geared for children:
http://earplugstore.stores.yahoo.net/chearpr.html

Apart from attempting to lessen the amount Chloe hears these annoying sounds, you could try approaching the problem from other ways. Most people who have extreme sensitivities in one area are also over or under sensitive in other areas as well. You may find that if you attend to one sensory stimuli, you'll actually be helping decrease her sensitivity in another area such as her hearing.

For example, some children who are easily aroused or over stimulated are able to be calmer and more tolerant with the addition of extra weights. You could try such things as:
- weighted vest
- weighted pillow placed on her lap
- a grain sack (tube of cloth filled with barley, etc.) then draped across her shoulders or on her lap
- one or two pound velcroed ankle exercise weights placed around her ankles or across her lap at the supper table

In addition to the beneficial feelings that weights can give, the sensation of pressure can also have a calming effect on a child's system. You could try such things as:
- a bear hug vest
- a snug, neoprene tank top under her clothes
- snug biker-type shorts
- a snug turtle-neck top

Other kids will take comfort in various types of movement. It's amazing how even just five minutes of this movement can have a calming effect that will last for the next while (at least long enough for Chloe to have a peaceful dinner with her sister). Try activities like these:
- swinging
- rocking in a rocking chair
- jumping on a trampoline, rebounder or mini-trampoline
- sit on an exercise therapy ball
- go for a run

I've given some other suggestions on this site:

http://www.autismsite.ca/html/hands_in_pants.html

There's a book that you might find useful, called "Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World" (http://www.amazon.com/Asperger-Syndrome-Sensory-Issues-Practical/dp/0967251478/r...).

Do you have access to an Occupational Therapist at your school? OT's are knowledgeable about sensory issues are can help you find what strategies would make your child more comfortable.


Sometimes, no matter how hard you try, there are going things that Chloe faces that are hard for her to tolerate or to understand. When that happens, social stories are a good way to give her coping strategies. Social stories are excellent for kids on the autism spectrum. If you're not familiar with the concept of social stories you can find information in places like these:

http://www.polyxo.com/socialstories/

http://www.adders.org/socialstories.htm

http://www.autismnetwork.org/modules/social/sstory/index.html

http://www.autismsite.ca/html/using_social_stories.html

Although these may seem like simple things to try, they can have a profound effect on some children. Social stories can help kids find a way to function in situations that make little sense to them.

On the sensory side, her bodies may not be processing sensory information in the same way as you. Her body may be receiving too little feedback or too much, creating an uncomfortable imbalance. By helping your daughter take "body breaks" where she gives her body needed feedback (such as jumping, swinging, squeezing, etc.) you can help her achieve a more balances state in which she feels better able to deal with all the sensory input coming her way.

Much as you would like to make this all right for your daughter, Chloe may well experience some degree of hearing or other sensitivies all her life (although the degree and type may change). Part of your job as her mother is to teach her strategies that she can use to help her deal with these issues. Part of this teaching can involve finding what things (like earplugs) that will allow her to tolerate sounds, yet remain engaged with the rest of her family. It can also involved helping her keep her other sensory senses in balance which in turn can increase her tolerance levels for offending sounds.

Sharon A. Mitchell
www.autismsite.ca