Bathing, hair cutting/brushing/washing, teeth brushing, applying sunscreen, nail cutting, dressing, wearing long sleeves, wearing shoes and socks… I’m guessing that these are the types of activities that many Autistic kids struggle with. The thing that all of these self-care tasks have in common is that they carry a huge sensory demand.
For PDA kids it’s a double whammy because there is often pressure and expectations surrounding them too.
What is sensory processing?
Sensory processing is the way our brain perceives information from our environment and from within our body.
We have 8 sensory systems:
Our external senses:
- Touch- Tactile
- Hearing- Auditory
- Sight- Visual
- Smell- Olfactory
- Taste- Gustatory
Our internal senses:
- Vestibular- how our head is moving
- Proprioception- how our muscles and joints are positioned
- Interoception- sensation from our internal organs
Every person has individual preferences for each of these senses.
If a child is sensitive or over-responsive to sensory input, the threshold for what they can tolerate is much lower and we often see kids trying to avoid situations that have high sensory demands. If sensory input exceeds what they can tolerate, a stress response is triggered. This might look like hitting, kicking, throwing, yelling, anxious laughter, crying, running away or shutting down. For these children it is important to make accommodations to ensure their system does not become overwhelmed.
If a child is under-responsive to sensory input, we see children present in two ways. They may appear day-dreamy or lethargic and require increased sensory input to reach an optimal state. Or, they may seek out more of the input that their body is craving.
A child’s ability to cope with self-care tasks is going to be impacted upon by a whole range of factors. The behaviours that we see are just the tip of the ice-berg. Their threshold or tolerance changes day to day and is dependent on things like: sleep, hunger, thirst, temperature, sickness, fatigue, environment, people around them, the amount of structure, autonomy, pressure, expectations and demands. How well the environment matches a child’s sensory preferences is also a huge contributing factor. They might be able to cope with brushing their teeth one day, however it might be an impossible task the next.
I often think of the children’s story Who Sank the Boat or the saying “The straw that broke the camel’s back.” If you can reduce the sensory demands on your child, you might just keep their system regulated enough for them to be able to manage some of those everyday tasks.
What does accommodating sensory preferences look like in action?
At our house, hair cutting is a good example of how we try our best to accommodate our PDAer’s sensory needs. Our son is sensitive to auditory and tactile input. When he was younger, he had some tremendously traumatic experiences at the hairdressers.
For many, letting your child’s hair grow long is a completely acceptable option for avoiding haircuts. For our son, he has expressed to us that he wants his hair kept short and doesn’t like hair in his eyes. He also finds it really challenging to have his hair brushed or washed on a regular basis so having it cut every few months is the lesser of two evils.
Our son has been able to tell us what it is that bothers him most about haircuts. He can articulate that he doesn’t like hairs getting on him, that he doesn’t like his hair being pulled, and that he dislikes the sound of the scissors. He also has a fear of his ears getting snipped, and the towel that we use as a cape falling off, which would lead to hair getting under his shirt and on his legs too.
Together, we have come up with some solutions. I cut his hair at home, and I hold the hair as I snip so that the majority of the hair doesn’t fall on him. Our PDAer wears a smock and also has towels covering his neck and legs. I have to be as gentle as possible. He wears earmuffs to reduce the noise of the scissors, and this also acts as protection which reduces his fear of his ears being accidentally cut. While his hair is being cut, he watches a favourite show. We stop whenever he says he is finished, which sometimes means that it takes a few goes to get a full haircut. Our son gets to choose when his hair gets cut and we eliminate every other possible demand in the lead up. We also know that he will need lots of rest time to recover afterwards.
How can you help to accommodate your child’s sensory preferences?
You know your child and their unique needs best. Figuring out how to accommodate their sensory preferences is going to take some trial and error. The next time your child is struggling to tolerate a self-care task, take a moment to consider if sensory input might be contributing. See if there might be ways that you can change the task to accommodate their sensory needs. Get your child’s feedback, dig down to see exactly what it is about the task that is tricky for them. Problem-solve with them to work out how you can work together to make things easier. And remember that you always have the option to shelve things that just aren’t high on the priority list right now.
If you want to know more about sensory processing, I highly recommend Lucy Jane Miller’s book Sensational Kids.
