Co-authored with Miranda Melcher
As discussed in a previous blog, sensory issues are essentially someone finding touch, sound, light, taste, or other sense-based stimuli either too much or too little in their effect, compared to the range of “normal.” These issues can often be unnoticed, including by the affected person, since what is considered normal is subjective, making it hard to understand someone else’s range of sensory reactions compared to one’s own. However, being oversensitive to sensory stimuli can have a problematic effect on one’s ability to function as expected.
Sensory issues are often underdiagnosed because of the subjectivity issues noted above and societal pressures. The subjectivity of understanding any individual’s sensory perceptions, and understanding that yours differ from others, can take years to fully develop, much less convince others of. Even when sensory sensitivities are acute enough for clients and their families to develop coping mechanisms unconsciously, it’s infrequently explicitly discussed. So, you should ask your client about and observe their reactions to:
- Light (brightness, inside versus outside, colors of light, screen color or brightness)
- Heat (temperature, humidity, sunburn, wind)
- Sound (total amount of noise, difficulty filtering out background noise
- Tactile sensitives (i.e., shampoo or thick liquids, clothing material or tags, toothbrushing or oral input, hair brushing, amount or proximity of touch, touching “messy” things like sand, glue, etc.)
- Taste or texture of food (mushy, spicy, acidic, mixed tastes, mixed textures, mixed colors requiring visual food separation)
Treating Environmental and Sensory Issues
For most sensitivities, there are two main options: change the environment or find protective/adaptive mechanisms for the individual to use regardless of the environment.
A wide variety of interventions can help address sensory and environmental issues, but they are highly specific to each individual. The best way to start developing effective strategies for your client is to ask them what is most impacting them (see previous blog on listening to your clients). Experimentation will likely be needed to find the right combination of methods for the best results. When in or heading to unfamiliar environments, encourage your client to protect themself actively and to collect as much environmental information as possible about new situations in advance so that appropriate interventions, adaptations, and psychological planning can be implemented.
The following describes some interventions for various sensory and environmental issues, but these should be considered very much as examples rather than overarching or guaranteed recommendations from the authors.
Light Sensitivities
One can change the method of lighting rooms as needed for one’s own home. Upward-facing lights (like standing lamps) with yellow bulbs produce more diffuse light than floor-facing overhead bright white lights. Light bulbs are available in different colors. Colors like candlelight and warm white have lower color temperatures than neutral white and daylight and may be more suitable for people with light sensitivities. For an additional discussion of light temperatures (Broitman et al., 2020).
Unfortunately, extremely bright overhead white lights are utilized in many academic and public spaces. Therefore, we recommend experimenting with tinted glasses. Some clients in our experience have had success with gray, black, dark yellow, and brown, dark glasses, essentially traditional sunglasses, worn in these spaces. Another aspect to keep in mind when trying on glasses is the feel of the glasses themselves, in terms of the weight of the frames, whether your client feels comfortable with nose pads, the extent to which the frames are visible to the wearer, etc.
Temperature, Humidity, Sunburn, Clothing, and Tactile Issues
For temperature, humidity, sunburn, clothing, and tactile issues, the key will likely be adapting outfits to accommodate layers of different materials and weights of fabric, as it is generally harder to change the temperatures/environments a client is exposed to, and therefore the focus will likely be on creating adaptive strategies. There are options like sun-protective clothing or powder-based sunscreen, which could be useful in some situations for clients who do not like the thick feeling of regular sunblock. For heat sensitivities, options like sweat-blocking wipes, anti-chafing/sweat creams, removable perspiration pads, etc., can also be effective.
Heat issues may also arise when learning skills like cooking, in which case focusing on learning recipes that require minimal long-term interaction with stoves/ovens (i.e., through one-pot, instant-pot, or “throw in the oven and roast”) is likely to be a better starting place.
Sound
For sound issues, there are a variety of possible interventions, depending on the specific subproblem being addressed. For being overwhelmed with the sheer level of noise, foam earplugs used for professional shooters can often be bought in bulk and are more flexible and comfortable than generic earplugs without being much more expensive. They can also be used in more public places than more visible ear protections that may be socially problematic or at night to ensure high-quality sleep. However, over-ear noise protectors or noise-canceling headphones might also be a useful option.
It is very difficult to filter out relevant noise from background noise, so encouraging your client to minimize the frequency with which they must endure these environments is best. If required to be in these atmospheres, sitting with their back against the wall or, ideally in a corner will allow your client to use visual distinguishers to help differentiate between different conversations.
In classrooms, an FM or Bluetooth lapel microphone on a teacher can transmit directly to the impacted student, eliminating the element of background noise.
Tactile Issues
For tactile issues, clients with both sensory issues, as well as anxiety issues have found weighted blankets soothing, so much so that these products are now widely available through large commercial websites. One thing to note, however, is that these weighted blankets are still relatively light; should your client want a heavier blanket, specialty autism order sites are likely the better solution than mainstream commercial options.
In terms of clothing issues, the guiding rule is likely to be soft and relatively seamless, for which there is an increasing range of options. Still, it may take some experimenting to find particular materials, cuts, or brands that work best for your client. In addition to fabric type, understanding your client’s preferences in terms of the collar (tight, loose, close, or far from the neck, etc.), general fit (tight or loose), sleeve length (around the wrists or not), etc. may be particular areas worth focusing on.
Psychological Fallout
In addition to tackling the sensory challenges, coping strategies for the psychological aspects of dealing with difficult environments are needed. Clients may have anxiety about being exposed to intense sensory stimuli, especially as there are often behavioral expectations learned before sensory sensitivities are understood and addressed, including having their feelings minimized or not believed. Furthermore, because sensory responses are subjective, clients may take time to become aware that their reactions to sensory stimuli warrant additional support. Therefore, sensory sensitivities must be treated holistically both as an expression of a neurological difference and also with a strong psychological component. Clients may need assistance to overcome long-lasting psychological issues due to repeated experiences of others who ignore/repress their sensory reactions.
Miranda Melcher is an expert on neurodiverse inclusive education and co-author of the book NVLD and Developmental Visual-Spatial Disorder in Children.
References
A full list of diagnostic questions to check for sensory processing issues can be found in places like Sensory-Processing-Disorder.com, and in Appendix 8 and 9 of NVLD and Developmental Visual-Spatial Disorder in Children (2020).
Margolis and Broitman, (2023) Learning Disorders Across the Lifespan: A Mental Health Framework, Springer
Broitman, J., Melcher, M., Margolis, A., & Davis, J. M. (2020). NVLD and Developmental Visual-Spatial Disorder in Children. Clinical guide to assessment and treatment. Springer
Broitman, J., & Davis, J. M. (2013). Treating NVLD in children: Professional collaborations for positive outcomes. New York: Springer.