The Need to Understand Irregular Sensory Regulation
Ian*, one of my regular patients, usually starts his Shiatsu session with significant delay. He walks slowly and often stands for minutes, weaving his body, before going through every door. Before we get to the room where the Shiatsu sessions are held, several minutes have typically passed. The Shiatsu mat is ready on the floor with a blanket on top of it, and Ian stands next to it, refusing to lie down. Like many people with autism spectrum disorder and complex needs, Ian has sensory difficulties that make participation in the session difficult for him.
Understanding sensory regulation
People with autism often experience irregular sensory regulation requiring substantial attention.
Our sensory organs are continually receiving stimulations from the environment. It is the nervous system’s job to regulate the senses and distinguish between the relevant stimuli and those who are irrelevant to us at any specific moment. Without the regulating function of the nervous system, we would not be able to concentrate or be adequately emotionally or physically functioning. Functions such as sleep, speech, balance, movement and more are affected by irregular sensory regulation. Many people with autism are often affected by irregular sensory regulation, and we must keep that in mind whenever we communicate with them.
Which senses should I focus on?
In addition to the five “common” senses (sight, hearing, smell, touch, and taste) I recommend taking into account the less recognized senses: balance, proprioception (feeling the location of the body organs and limbs), pain, hunger, tiredness, temperature, spatial sense and more.
People with autism might experience different stimulations in excess or deficiency, which may cause them to avoid specific stimuli or to seek particularly strong ones. For example, some people with autism cannot stand loud noises, preferring calm, while and others feel the need to rock or throw themselves against walls. Often, a person with autism can experience a combination of excess and deficiency in different senses.
Finding new ways to manage autism
“Ian, do you want the blanket or not?”
Ian smiles as he looks at the blanket and after some time answers, “No blanket.”
I remove the blanket and Ian, smiling, lies down on the mat. The Shiatsu session can begin.
When taking into account the various possibilities of irregular sensory regulation, and through trial and error, it is possible to discover creative solutions to encourage people with autism to take part in various activities.
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In the case of Ian, I understood something in the Shiatsu mat bothered him, and through some thought and exploration, learned the problem was either the color or the texture of the blanket I used to cover the mat. Sometimes Ian refused to lie down if I removed the blanket ahead of the treatment, and I had to realize that occasionally Ian wanted to have the blanket on, and I should give him an opportunity to make a decision each time. That realization was a significant step forward for me in working with Ian, as he seemed to enjoy making his choices each time.
I would like to point out that the prolonged time Ian required to answer my questions and to pass through doors can also be the result of irregular sensory regulation. The ability to execute a thought, through action or words, requires the combined activation of several systems (emotion, speech motor particles, decision making, choosing appropriate words, calculations of probable outcomes and more). Passing through a door is stepping from one space to another, which requires a quick processing of many sensory stimulations and accustomization to a different environment.
The search for creative solutions for people with autism is a necessary step on the way to making them more involved in various activities and allowing them more freedom of choice. Neurotypical people might take this freedom for granted, but it is not necessarily the case for people with complex needs.
* Not his real name
This is article was featured in Issue 73 – Amazing Ways To Support Autism