Many parents experience the “picky eater” from time to time. As with most differences on the autism spectrum, the difference in describing the picky eater with autism can be found in the intensity or degree.  Because of this relative understanding, one might be critical of the parent with a child with autism and tell them they just need to make their child eat food that is more nutritionally sound. But the “picky eater” is really just someone with sensory processing issues in regards to taste.

I was in a meeting where the educators and the parents were discussing the narrow food choices of the daughter as being a nutritional and even behavioral concern. At one point, one of the educators told the parents that she, herself, had a picky eater, and that she just had to lay down the rules and “force” the issue. The teacher proceeded to tell the parents that they should do the same thing. The mother became upset very quickly and in a raised voice told the educator, “Don’t you think I’ve tried everything to make her eat healthy?! I’ve had food spit out at me more times than I can count, and I’ve had the kitchen torn apart after a food-related meltdown . . . I’ve done it ALL!!!” 

I am trying to make the point that we are talking about a matter that goes beyond “picky eating”.
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First, let’s have sensory processing disorder explained by someone with a personal experience with it. Watch this video of Amythest Schaber, a person living with an autism spectrum disorder.

Differences in auditory processing are one of the more commonly reported sensory processing impairments. In one chart review of developmental patterns in 200 cases with autism 100% of the participants demonstrated difficulties with auditory responding.Continue Reading

Aspergers101 Medical Vlogs is a series provided by the Autism Community Network. This is the first in a series on the topic of Sensory Processing.

In this clip, Adrienne Gaither, OTR, C-SIPT , answers the question: What causes Sensory Processing Disorder (SPD)?

narrative

Although sensory differences are very real and must be recognized as such, narratives can help to deal with these differences. For instance, there was a high school student that was having significant difficulty with the hallway transition from class to class. Not only was there the loud bell that signals the transition, but then it was followed by a crowded hallway and noisy teenagers talking in groups.

narrative

 

One way to address this might be to allow an early release from class to avoid much of this hallway chaos. Another option is to provide a narrative that helps deal with this difficult transition.

The following is an example of such a narrative:

Passing Period at High School

My name is ___________. I am a student at _________ High School.

In High School, there are different periods. A bell rings at the end of each period.

When the bell rings, the students walk in the hall to go to their next class.

Sometimes, the students make a lot of noise as they walk down the hallway. This might hurt my ears.

That is O.K. The passing period lasts only for a few minutes. Soon, the halls will be quiet again.

I remember that I can just wear my headphones & listen to music during the passing period.

Then, I will get to walk to my next class where it is nice and quiet.

I can do this!

Staff noticed that the student would repeat the story to himself while walking down the hall. A narrative can validate feelings, provide a solution and even offer comfort during a stressful time.

The following is another example of a narrative addressing sensory issues. This time, the narrative was written for a student that wanted to hug her classmates frequently and deeply to get that deep pressure feeling.

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Sensory processing disorder (SPD) can make participation in life activities—what occupational therapists refer to as occupations—very difficult. Luckily, there are options and strategies to help improve sensory processing and make life much smoother and more enjoyable.

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Sensory-based occupational therapy (OT), may look like play to adults, but to the child it is their work and necessary for improving overall abilities to process sensory information more appropriately. Jumping, swinging, climbing and playing in multisensory mediums—such as shaving cream, beans, rice, or play dough—all have a place in their growth and the development of sensory processing abilities.

As the child plays and learns more about their body and how to use it through treatment for sensory processing disorder, their brain improves its ability to process sensory information more efficiently. These children are then able to handle situations more appropriately and participate in everyday activities including self-care, fine motor and social skills.

This process can take months for long lasting effects, but parents often see a difference after the first few visits.

Occupational therapists that specialize in SPD and autism are especially adept at helping individuals on the spectrum succeed. These therapists are skilled in testing and providing treatment, compiling strategies to modify the environment, developing home programs, and giving suggestions to schools and vocational programs to improve participation in life’s activities.

When looking for an occupational therapist, it is important they have advanced training in sensory integration or SPD and, if possible, are SIPT (Sensory Integration and Praxis Test) certified.

Though occupational therapy services may be provided in a variety of settings—including home and school—the clinical setting is much more conducive to treating SPD and the underlying causes of the child’s difficulties. This is because a clinic will have specific equipment designed to promote engagement in therapy and develop skills necessary to overcome sensory difficulties.

You also want to make sure they have an OT gym that is well equipped to treat SPD.  A phone call and an interview with the therapist may be beneficial.

Find a SIPT Certified Therapist

by Dr. Gayla A. Aguilar, OTR, OTD

Does your child have a sensory processing disorder? How does your occupational therapist help?

Since feeding involves all sensory systems (sight, smell, sound, touch, and taste), eating is the most difficult sensory task that children face. Feeding issues are especially common in children with autism, including those with Aspergers, because of difficulties with sensory processing. In many cases, this leads to eating challenges at mealtimes.

Little girl eating

“Food chaining,” from the book by the same name, is based on the child’s natural preferences and successful eating experiences—specifically the idea that we eat what we like. Food chaining introduces new foods that have the same flavors or sensory features as foods that are already preferred by the child, increasing the likelihood that the child will like the food.

A food chain consists of four levels that build upon one another. By following the levels of the food chain, the child will be able to build upon success with small changes.

For example, if your child’s accepted food is chicken nuggets, a sample food chain might look like this:

Level I Level II Level III Level IV
Maintain & Expand Current Taste & Texture Vary Taste & Maintain Texture Maintain Taste & Vary Texture Vary Taste & Texture
Other brands and sizes of chicken nuggets (i.e., strips/popcorn/bites, both fast food & home-prepared); fried chicken patties cut into pieces (fast food & home prepared) Different flavored chicken nuggets (barbeque, honey mustard, hickory smoked, etc.) Use sauces/dips to vary tastes. Chicken strips (not breaded); chicken leg/drumstick; chicken breast; ground chicken patties Breaded seafood (scallops, shrimp); breaded fish (fast food & home-prepared); breaded turkey breast; breaded vegetables; breaded baked chicken; crusted/breaded pork tenderloin; ground meats

Here are some other food chaining tips:

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Many children with sensory processing disorder or related issues can have difficulties in the school setting. Problems can arise anywhere: in the classroom, cafeteria, gymnasium, hallway, playground, and even the bus. Some of these issues can be as subtle as not eating lunch, or as difficult as destroying a classroom.

Knowing what causes these problems and how to prevent them is important for both the school and the child. This is where parents can be the best advocate for their child with Aspergers or HFA and sensory issues.

Preparing a child for school is important, but it is equally important to prepare the school for the child.

Sharing their sensory concerns with the teachers, para-professionals, principals, and others is imperative to limiting sensory difficulties in the classroom.

A typical plan should include setting up a sensory-friendly classroom with a place for the student to “get away” if necessary, providing sensory activities throughout the day to help prevent problems that may arise, catering to sensory diets, and preparing the student for changes or surprises that may come up.

A school occupational therapist can help make all of this easier, if they get involved. The occupational therapist can help teachers discover problem areas and learning differences, while providing suggestions to improve success.  Some ideas they may implement include setting up lunch bunches to relieve lunchtime stresses, providing sensory activities to use throughout the day that support the student’s ongoing needs, or modifying instruction for classroom success.

Together, the parents, teachers, and occupational therapists can develop a program that is individualized for the student with sensory issues and make this year both successful and rewarding.

For more information on sensory friendly classrooms and teacher resources, go to Future Horizons Inc. There are multiple books and other resources to help the teacher prepare for these students.

by Dr. Gayla A. Aguilar, OTR, OTD

As with the senses of sight and hearing, sometimes one or more of the senses are either over- or under-reactive to stimulation. This is also true for the sense of touch. For some persons with an Autism Spectrum Disorder, certain textures feel uncomfortable or even painful. For these individuals, the idea of a hug or even accidentally brushing up against something may be highly stressful. In order to prevent this negative tactile experience, much energy and focus is spent avoiding situations that increase the likelihood of such events.

Painted hands for a border

Imagine lining up where there are others in front of you and behind you. The chances of being accidentally touched by either person may cause the simple act of lining up to be highly stressful and anxiety provoking. For individuals that do not like the feel of certain textures or things, parents and teachers may consider the following types of supports:Continue Reading

Remember in our previous blog on taste differences that smell makes up a large part of our sense of taste. Therefore, an individual with an Autism Spectrum Disorder might have an extremely fine sense of smell, which can be enough to make them avoid certain foods or even lose their appetite. So, there might be overlap in this very complicated topic of sensory differences as they co-exist in each person.

“Our sense of smell is so deeply ingrained in our psychology that many times we don’t even realize how scents are affecting what we do and how we think. Smell, more so than any other sense, is also intimately linked to the parts of the brain that process emotion and associative learning. Meaning that our sense of smell influences our feelings and perceptions neurologically. Our brains are hardwired to perceive certain smells and have an emotional reaction to those smells.”

Excerpt from: http://science.howstuffworks.com/life/human-biology/smell.htm

Smell might be a hidden source of discomfort and even anxiety for some persons with ASD. “Hidden” in that a neuro-typical individual might not perceive a particular smell that registers heavily for the person with ASD.

I am reminded of a few instances where smell was a critical factor in the daily happenings of certain individuals with an ASD.

One young man with limited verbal capabilities would protest behaviorally when it was time to go to the restroom. Mind you, this was a boy’s restroom at a high school. After some careful analysis and problem solving, the staff decided to try changing the restroom from the boy’s restroom to the teacher’s restroom.Continue Reading

Aspergers101 Medical Vlog series looks at Sensory Processing. In this clip Adrienne Gaither, OTR, C-SIPT with the Autism Community Network, answers the question: Is Sensory Processing Disorder (SPD) Treatable?

The Autism Community Network is located in San Antonio, Texas USA with an emphasis on collaboration with autism service providers, early diagnosis, and providing services to underserved young children and their families.