Silk, cotton, velvet and cashmere; does the thought of these fabrics against your skin evoke a strong tactile sensation? For autistic children, the feel of fabric is a powerful force with the potential to bring about a meltdown or deeply soothing comfort.
A memory that lingers long after my grandmother’s death is the way patients fiddled with pieces of fabric on the Altzheimer’s ward where she spent her last years. I remember my gran, her still elegantly manicured hand stroking the yarn of a blanket repeatedly, the texture bringing comfort when little else could.
Fabrics can offer comfort to many. Often babies need a specific blanket to fall asleep, just as many adults need the feel of a specific sweater to wind down after a long day. However, for kids on the spectrum, sensory input from their environment may determine their wellbeing more significantly. Socks with a hem, scratchy labels, and tight clothing have all been noted as causes of a meltdown for children with autism. This may be due to sensory processing issues, which almost all children on the spectrum have to some degree.
Sensory processing disorder
Sensory processing disorder is seen in many children with autism and generally means they are either hyper- or hypo- sensitive to sensory input. A child may overreact to input from the environment (hypersensitivity) or they may be sensory seeking; constantly searching out stimuli from their sensory environment (hyposensitivity).
Sensory processing differences are complicated. A child may be hypersensitive to some sensory stimuli like visual input, while at the same time displaying hyposensitivity in other sensory areas, for example seeking proprioceptive input by crashing into furniture.
Tactile choices
Touch or tactile hypersensitivity may mean your child on the spectrum reacts differently to the feel of fabrics on their skin, in comparison to neurotypical children. When a child with autism insists on wearing pajamas or a specific well-worn shirt all the time, the softness of the fabric may be the only material they find tolerable due to tactile defensiveness.
Tags in clothing could be another minefield. Parents with kids on the spectrum report that, even when cut out carefully, the miniscule remainder of the tag may mean the article of clothing is never worn again. Another parent told me about his child who cannot stand the sensation of denim fabric. The child was supposed to wear jeans to a school ceremony where he would have received an award. He ended up missing the ceremony he had been looking forward to as he could not stand the idea of wearing jeans, but did not want to be the only kid in a different outfit. Tactile defensiveness is not a child being finicky: kids on the spectrum describe the feel of certain materials as “torturous” on their skin.
For other children, hyposensitivity means they are constantly seeking input with behaviors like fidgeting and fiddling with materials of a preferred texture. These kids love to touch everything, sometimes even licking non-food surfaces for the sensory input the texture of the surface provides.
A material issue
Parents dealing with the spectrum of autism symptoms may wonder if the choice of material or fabric when picking clothing is really important in the grand scheme of things. This question was recently addressed in a study titled Clothes, Sensory Experiences and Autism: Is Wearing the Right Fabric Important? (Kyriacou et al., 2021).
The study mentions the fact that sensory defensiveness is the least examined sensory modality in autism spectrum disorder (ASD), yet certain fabrics impacted the wellbeing of autistic adults who participated in the research. The authors believe better understanding of tactile defensiveness may lead to “increasing autism-friendly approaches with appropriate fabric”.
Choosing sensory soothing and seeking fabrics for your child
Parents obviously want to provide an environment that soothes and provides the appropriate amount of sensory input for their children with autism. Knowing your child and their preferences makes you the ideal designer of environments where they will thrive despite sensory issues. Here are some tips to help you.
Consider weighted blankets
If your child is always seeking sensory input, you could try a weighted blanket (approved by your child’s occupational therapist). These blankets are often created by companies who specialize in sensory processing disorders, so the texture or feel of the fabric used for the blanket may appeal to your child. Furthermore, the weighted blanket could provide the deep pressure your child is craving.
Make comfort pieces
Another great idea parents in the autism community have shared with is picking your child’s favorite fabric and creating a comfort piece (of material) which they can take with them when feeling insecure. You can order the sensory “pleasing” fabric from companies that provide additional printing or embroidery services. Parents often choose to print autism awareness and neurodiversity pride symbols on the fabric—although symbols like the autism puzzle piece may be controversial.
Offer choices and listen
When your child complains (verbally or through behavior) about the fabric of their clothes, try to listen with understanding. If your child is old enough and able to communicate preferences, consider including them when choosing clothing, bedding, and furniture. If your child picks (and approves) items of clothing when shopping together, they are more likely to wear it and feel comfortable.
Find the right bedding
The same applies to bedding. Some children on the spectrum prefer a heavy duvet as they crave the pressure it provides. For other children, very light cotton bedding and pajamas made of breathable materials are a must.
Consult with professionals
There are many specialists, including occupational therapists, who can help and advise parents about choices for children with tactile defensiveness. Therapists may suggest treatment options like the Wilbarger Brushing Protocol for children with autism who experience daily struggles due to tactile defensiveness and other sensory issues.
As the sensory symptoms of autism are being researched more thoroughly, businesses and designers are working on ideas to help make the world, and children’s home environments, a more sensory friendly place. Many parents start with their kids’ bedrooms to create a calming sensory space. From there, taking stock of all offensive items of clothing and hygiene products may be needed. Speak to your child’s doctors and therapists before embarking on any sensory integration therapy or modifications.
Sensory deficits are no small matter
Despite sensory processing disorder being largely ignored by conventional doctors, many researchers are noticing the significant role it plays in children’s lives. A recent study (Reda et al., 2021) aimed to determine the relation between sensory processing disorder and core autism symptoms (communication and social interaction deficits and stereotypic behavior).
The study found a significant negative correlation between sensory processing disorder and these core autism symptoms, and emphasized the importance of sensory integration therapy as vital to autism treatment. A child who refuses to wear a scratchy shirt or sleep under a polyester blanket is not being difficult; they may be dealing with a sensory system unable to process texture and the feel of fabric on their skin in a typical way.
References:
Kyriacou, C., Forrester-Jones, R., & Triantafyllopoulou, P. (2021). Clothes, Sensory Experiences and Autism: Is Wearing the Right Fabric Important?. Journal of autism and developmental disorders, 10.1007/s10803-021-05140-3. Advance online publication. https://doi.org/10.1007/s10803-021-05140-3.
Reda, Mona & Meguid, Nagwa & Eid, Ola & Hussein, Fatma & Elalfy, Dina. (2021). Study of sensory processing deficits in autism spectrum disorder symptom triad: an Egyptian sample. Middle East Current Psychiatry. 28. 10.1186/s43045-020-00082-5.
