Auditory Problems
Auditory challenges are often cited as the #1 sensory challenge among individuals with autism/Asperger's. There are two kinds of auditory problems: 1) sensitivity to loud noise In general and 2) not being able to hear auditory detail, such as discerning one voice among other sounds, or hearing the hard consonant sounds of words. An auditory sensitivity to noises, where sounds hurt the ears, can be extremely debilitating. Sound sensitivity can make it impossible for some people on the spectrum to tolerate normal places such as restaurants, offices, and sports events. These extreme auditory problems can occur in both nonverbal individuals and those who are very high-functioning with marked intelligence and language capabilities, such as college-educated people with Asperger's.
Auditory training therapy is useful for some people. In auditory training, a person listens to electronically distorted music a couple of sessions a day for ten days. The music sounds like an old-fashioned record player that is speeding up and slowing down. AT helps some children and adults, yet has no effect on others. The main improvements seen in those that it helps include reducing sound sensitivity and increasing hearing of auditory detail. For many children, getting their auditory input under control results in improved concentration, fewer behavior issues, and gives a chance for other therapies and learning situations to take hold. Some people with more minor auditory challenges use earplugs or music headphones to block out distracting or painful sounds, things such as chairs scraping on the floor in the cafeteria, the constant ringing of telephones in a busy office, or maneuvering through a crowded airport. Earplugs must never be worn all the time; this can cause the individual to become even more sensitive to sound. They need to be off at least half of the day, but can be used in noisy places such as shopping malls or the gym.
An Integrated Approach to Treatment
Severe sensory sensitivity can be a MAJOR barrier to learning in children, and in employment and socializing as the child grows and becomes an adult. My own sensory problems are minor nuisances, but for others, they can literally wreck the person's life. There are many highly inrelligent adults with ASD or Asperger's, with brilliant minds in their field, who have such severe sensory issues that they cannot tolerate a normal job environment. They must either find ways to work independently from home, where they can control sensory input, or remain largely unemployed. Employers are beginning to understand sensory issues and some will even make accommodations when the needs of the person are explained. However, on the whole, we as a society have far to go in appreciating the challenge of living with sensory issues that most people on the autism spectrum face daily.
Teachers and parents should look closely for sensory issues in a child or young adult. Recurring behavior problems often have a sensory issue as the root cause of the behavior. If a sensory issue is suspected, a consultation with a good Occupational Therapist should be the next step. These individuals are trained to recognize sensory issues and then develop a customized program for the child. Interventions such as deep pressure, slow swinging, and games involving balancing work best when they are done every day.
Sensory issues are daily issues. If the services of an OT are available for only half an hour each week, parents and teachers should visit the session and ask the OT to show them what to do the rest of the week. For children, a combination of sensory therapies such as sensory integration from an OT, auditory training, and visual interventions coupled with other treatments works best. Special diets help some children with their sensory issues; improvements are seen not just in tolerating different textures and types of food, but also in other sensory areas as well. With older children and adults, a little dose of a conventional medication may reduce sound sensitivity if less invasive methods have proven unsuccessful.
Temple Grandin "The Way I See It: A Personal Look at Autism & Asperger's" (2011)
