Supporting Loud Sounds: Coping with Auditory Sensitivities

By: Jolie Rosenthal, Occupational Therapy Student (OTS), University of New Hampshire

As summer progresses, so does the frequency of your child experiencing loud fireworks, roaring hand-dryers in the public bathrooms at the beach and pool, and the variety of sounds of other children playing outside.  All of these sounds can be considerably triggering for a child with auditory sensitivities. Loud noises can provoke anxiety, rage, and irritability for children with auditory sensitivities. As difficult as it is for the child to deal with, it may cause extensive stress for parents as well. There are various coping mechanisms, tips, and techniques that can be implemented to help mitigate the undesirable effects of auditory triggers on children.

Noise cancelling headphones or earbuds (One you probably know)

  • Noise cancelling headphones can be kept in the car or your handbag for easy access in any situation in which the environment will be auditorily overwhelming for children like firework events and outdoor concerts.
  • Regular earbuds can be used to play soothing white noise and relaxation inducing audio frequencies which may distract from or cover up the loud auditory stimuli and comfort the child.

Give warnings and prepare

  • Children can be warned before certain sounds occur like those produced from vacuums, toilets, and hand dryers.
  • Inform your child that there is going to be a loud noise and to cover their ears; show them how they should cover their ears, and count down slowly before turning on the vacuum, hand dryer, or flushing the toilet to give your child time to prepare.
  • Before entering loud environments like a concert or fireworks event, do some ”heavy work” movement activities with your child which can calm the child and decrease feelings of sensory overload. Heavy work involves activities in which one is exerting oneself and receiving feedback from the body. Examples include: going on monkey bars, using a bicycle, digging in the sandbox, and practicing yoga (GriffinOT, 2021).
  • Putting on compression clothing before entering a triggering environment can increase the child’s comfort as well.

Coping with the noise – What are my tools?

Oftentimes, loud noises make children upset and they may need a way to release their emotions. Taking a break and removing your child from the auditory triggers can be helpful, but is not always able to be done. In relaxed calm settings, pre teach your child how to use some “tools” for their calming toolbox when they become overwhelmed by sounds.  Then when you are in the situation they will have an idea of how to use some of these simple calming tools:

  • Children can chew safe rubber chewing jewelry like necklaces and bracelets.
  • Stress balls can help children channel emotions.
  • Take three to five deep breaths in through the nose and out through the mouth and hold for a few seconds. This is one of the best ways to calm down.
  • Engaging in a hands-on activity is another way to distract our mental brains from the fact that we don’t like the sounds.  Simple toys and activities like a coloring page with markers, playdough in a ziplock to squeeze, or drawing in a sketch book can help calm our minds (S. Smith, personal communication, July 19, 2021).

Give your child the control

  • Let your child flush the toilet, turn on the hand dryers, and start the vacuum so they can take the time they need to get ready for the noise. Plan and build in extra time in louder environments sometimes so that you don’t feel rushed in these situations.
  • Encourage communication between you and your child so they can recognize triggering stimuli and notify you before the situation escalates.
  • Let your child be in control of carrying their own noise headphones, chewing jewelry, and other materials that may be soothing to them.

References

Griffin OT. (2020, August 30). The mystery of heavy work. GriffinOT. https://www.griffinot.com/the-mystery-of-heavy-work/

Travel Tips for Tactile Sensitivities

Spring break is coming! For many of us, spring means enjoying the sun over our heads and the sand under our toes. Many sensitive children, however, find trips to the beach or other exotic locations unbearable. This month, we’re going to focus on some common tactile triggers you might encounter on vacation. 

No matter what your child’s particular triggers are, remember that preparation is key. Have her help you problem solve, plan, and pack as much as possible. Try new clothing or toiletries at home and make sure she has a chance to give input on each item. Above all, be honest about what to expect in your new environment and give her as much control over her own comfort as possible.

Keep reading for some common tactile triggers and a few tips for tackling each. Also, be sure to check out our previous article for some more general tips on traveling with sensory needs.

#1 – Sunscreen, lotion, and other toiletries

  • Make sure to test every new product at home before you leave.
  • Pack enough for your entire trip–you might not be able to find certain items elsewhere.
  • Experiment with different types of applications–sunscreen sticks, shampoo bars, etc.
  • Minimize the need for sunscreen by using sun shirts, hats, and protective clothing.

#2 – Unfamiliar or uncomfortable bedding

  • Bring pillows, blankets, sleeping bags, or stuffed animals from home.
  • Make bedding smell and feel familiar by bringing your own laundry detergent.
  • Bring a favorite blanket to act as a barrier/comfortabel layer under the sheets.

#3 – Sand and unusual textures or temperatures

  • Experiment with different types of shoes–open vs. closed sandals, water shoes, etc.
  • Minimize exposure by wearing pants or gloves while playing on the beach.
  • Try playing on different parts of the beach–loose, dry sand vs. wet, packed sand.
  • Bring ice packs, hand warmers, etc. to help regulate temperature.

#4 – Insect repellant and bug bites

  • Minimize exposure by wearing long sleeves and pants when possible.
  • Experiment with different types of applications–wipes, wristbands, clips, sprays, etc.
  • Use bug zappers or burn citronella candles or sticks when outside.
  • Experiment with alternative repellants, such as essential oils.
  • Pack hydrocortisone cream or ointment to soothe bites and stings.
  • Be aware of your location–bugs are more prevalent by the water or in wooded areas.

#5 – Being crowded or bumped in public places

  • Call ahead and see if your destination has accommodations for sensory sensitivities.
  • Practice waiting in line at the grocery store or other crowded location.
  • Practice deep breathing and anti-anxiety techniques. 
  • Talk it out–remind your child that people who might bump into her are doing it accidentally and are not trying to be rude or hurtful.

How to Introduce New Foods

If you’ve got a gustatory avoider or olfactory avoider, you know how difficult it can be to get through a typical meal, let alone trying to introduce new foods. However, we know that eating a variety of good foods is the best way to stay healthy. So how do you go about getting your picky eater to try new foods?

Before you start: Make the place and time are consistent and the atmosphere is calm. Chaotic family dinners may not be the best time to try new foods, as there are so many potential distractions and sensory triggers. Once your child is calm and regulated, have him move through the following steps at a comfortable pace.

How to Introduce New Foods:

  1. Tolerate the food on the table, but not on his plate.

  2. Tolerate the food on his plate.

  3. Touch the food with utensils.

  4. Touch the food with his hands.

  5. Hold the food up close to his face and smell it.

  6. Hold the food up to his lips.

  7. Touch the food lightly with his tongue.

  8. Bite down on the food and spit it out.

  9. Bite down on the food and hold a small amount in his mouth.

  10. Finally, bite down on the food and swallow.

Patience is key, as it might take several days—or even weeks—for your child to progress through each step. Remember, you should never force or coerce your child into eating. Moving at a pace that feels comfortable to him will allow him to feel more in control and less anxious.

Other Things to Consider:

  • Stepping out of your comfort zone can be stressful for anyone, especially sensory avoiders. Build in time to let your child calm down and relax after completing one of the steps above.
  • If he’s able, have your child help with the food shopping and meal preparation. This will let him get used to the sight, smell, and feel of new foods without having to taste them.
  • Try to introduce new foods in your child’s preferred texture. For example, serve raw fruits and vegetables if your child prefers crunchy foods. If he prefers soft foods, start with applesauce, mashed cauliflower, etc.

How to Support Vestibular Avoiders

Vestibular avoiders are highly sensitive to movement and tend to become overwhelmed by everyday activities such as play and travel. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support vestibular avoiders.

Vestibular Avoiders May:

  • Prefer sedentary activities, such as video games or reading.
  • Avoid swings, slides, monkey bars, and other playground equipment.
  • Feel off-balance or unsteady on slanted or uneven floors.
  • Become fearful when tilted backwards or are unable to touch the ground. 
  • Experience motion sickness or headaches after intense movement.

How to Support Your Vestibular Avoider:

  • Don’t lift, tilt, or move your child without giving a warning.
  • Hold your child’s hand while walking to provide grounding and support.
  • Use a footstool if your child’s feet can’t comfortably touch the ground while sitting.
  • Provide calm alternatives to playground activities, such as hiking or catch.
  • Teach your child to focus on a static point inside the vehicle to avoid motion sickness.
  • Work on calming strategies and develop a plan for how to exit overwhelming situations.
  • Provide a quiet place to lie down after motion sickness or headaches.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Gustatory Avoiders

Gustatory avoiders are highly sensitive to taste and tend to become overwhelmed or distracted by new, strong, or particular flavors. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support gustatory avoiders.

Gustatory Avoiders May:

  • Seem to have an unusually low appetite and/or be underweight.
  • Be “picky eaters” and have very specific food preparation requirements.
  • Avoid foods with specific flavors, such as sweet, bitter, or spicy.
  • Avoid foods with specific textures, such as crunchy, chewy, or mushy.

How to Support Your Olfactory Avoider:

  • Never force your child to eat.
  • Use a slow, tired approach to introducing new foods. LINK TO ARTICLE
  • Keep mealtimes calm and allow preferred foods to be on the menu.
  • Expose your child to new foods by having him/her help with shopping or cooking.

Note: Contact your pediatrician immediately if you think your child is not eating for any reason other than sensory issues.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

Learn to support visual avoiders.

How to Support Visual Avoiders

Visual avoiders are highly sensitive to light, color, or patterns and tend to become overwhelmed or distracted by everyday visual input. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for ways to identify and support visual avoiders.

Visual Avoiders May:

  • Seek out dark or secluded environments.
  • Avoid messy rooms and busy, crowded spaces.
  • Frequently cover their eyes or hide their heads under pillows or clothing.
  • React strongly or as if in pain to bright, strobing, or fluorescent light.
  • Perceive dim, normal, or natural as much brighter than it actually is.
  • Be bothered or distracted by objects with bright, reflective, or shiny surfaces.
  • Be bothered or distracted by objects with spinning, flashing, or moving lights.
  • Prefer clothing and toys with muted and simple shapes, colors, and patterns.

How to Support You Visual Avoider:

  • Avoid toys and games with flashing or blinking lights.
  • Keep curtains or blinds closed whenever possible.
  • Wear sunglasses, tinted glasses, or hats when needed.
  • Give advance warning of bright or unexpected light whenever possible.
  • Be conscious of colors and patterns in toys, décor, and clothing.
  • Replace bright overhead lights with dimmable floor, table, or desk lamps.
  • Be mindful of clutter, reflective surfaces, and lights from electronics or appliances.
  • Work on calming strategies and develop a plan for how to exit overwhelming situations.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Tactile Avoiders

Tactile avoiders are highly sensitive to touch or temperature and tend to become overwhelmed or distracted by everyday tactile input. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support tactile avoiders.

Tactile Avoiders May:

  • Avoid toys, clothing, or food with specific textures.
  • Dislike being touched, hugged, or kissed, even by parents.
  • Avoid getting dirty and avoid playing in sand, dirt, or grass.
  • Dislike their hair or skin being wet and avoid swimming and bathing.
  • Refuse to wear tight, scratchy, or uncomfortable clothing with seams or tags.
  • Avoid play with other children and constantly worry about being touched or bumped.
  • Become anxious in crowded spaces or when standing even somewhat close to others.
  • Have a low pain threshold and respond to even light touch as if in pain.

How to Support Your Tactile Avoider:

  • Remove tags from clothing and turn uncomfortable items inside out.
  • Put long hair up in a towel or hair tie when bathing or swimming.
  • Buy compression or athletic clothing to wear under loose or scratchy items.
  • Use gloves or tools to engage with new or unpleasant textures.
  • Encourage low-contact outdoor games, such as racing, tag, or tug-of-war.
  • Introduce new foods slowly and in the preferred texture, such as mashed or crunchy.
  • Warn family and friends ahead of time that hugging and touching is not desired.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Proprioceptive Avoiders

Proprioceptive avoiders are highly sensitive to movement and pressure tend to become overwhelmed or distracted by physical contact. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support proprioceptive avoiders.

Proprioceptive Avoiders May:

  • Avoid physical contact with others.
  • Appear very timid around peers and avoid physical play.
  • Refuse to play around slides, swings, and other playground equipment.
  • Become anxious in crowded spaces or when standing even somewhat close to others.
  • Be unable to properly assess risk in their physical environment. For example, they may believe they can fall into the small gap between the floor and an elevator.

How to Support Your Proprioceptive Avoider:

  • Warn family and friends ahead of time that hugging and touching is not desired.
  • Be attentive and comforting around playground equipment and other children.
  • Give verbal cues regarding your surroundings and properly contextualize the risks. (“There is a gap in the floor by the elevator. It is smaller than your foot. You cannot fall in. Let’s step over it together.”)

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Interoceptive Avoiders

Interoceptive avoiders are highly sensitive to internal bodily cues and tend to become overwhelmed by physical sensations. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support interoceptive avoiders.

Interoceptive Avoiders May:

  • Have disproportionately strong directions to normally bodily cues.
  • Constantly feel they are hungry, thirsty, or need to use the bathroom.
  • Feel pain more intensely or for a longer duration than others.

How to Support Your Proprioceptive Avoider:

  • Treat even very minor injuries as if they are substantial. Remember, they feel serious.
  • Use the bathroom or have a small snack before each new activity or transition, such as getting into the car or going to bed.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

Sensory struggles during the winter months

Sensory Struggles in Winter

Winter is here! For many of us, winter is a time of outdoor play, indoor coziness, and creating memories with family and friends. However, winter can bring a whole new set of challenges and for families with sensory needs.

This month, we’re taking a look at some common sensory struggles in winter and offer a few suggestions for keeping your child regulated, engaged, and safe during the cold months. Have another tip? Let us know in the comments!

Challenge #1 – Outdoor Winter Activities

Winter games like sledding, ice skating, and playing in the snow are generally great for seekers, particularly: tactile, vestibular, and proprioceptive. However, children with sensitivities and discrimination issues often struggle with these activities.

Proprioceptive and tactile avoiders may be unable to tolerate cold wind on their faces, fast movement, or being close to other children. Visual avoiders may become overwhelmed by the glare of snow and ice. Finally, those with vestibular, proprioception and visual discrimination disorders may have difficulty walking on snow or ice and keeping a safe distance from other children. 

Tips and Tricks:

  • Ease your child into new activities. Hold his hand and practice walking on ice and snow, slowly pull him around the yard in a sled, and help him pack snowballs.
  • Practice new or scary activities at home. Skate on the kitchen floor in your socks, have a snowball fight with socks or stuffed animals, or race to put on your snow gear.
  • Break down overwhelming or scary activities into small, manageable steps. (“First we sit on the sled, second we push, and third we lean back and ride.”)
  • Experiment with outdoor games and activities that don’t require being in close proximity to others, such as geocaching, Pokemon Go, or simply making snow angels.
  • Be mindful of seeking behavior in activities like sledding, skiing, and ice skating. If your child is being unsafe, try to figure out the sensation he’s craving and help him find other ways to achieve it.
  • Wear sunglasses or baseball hats to reduce glare from ice and snow.

Challenge #2 – Winter Clothing and Dry Skin

Even children without sensory issues can struggle with winter clothing. For tactile avoiders, however, getting into winter gear can feel completely overwhelming: sweaters are itchy, boots are heavy, coats are bulky and restrictive. They may find dry, irritated skin to be extremely painful but, along with olfactory avoiders, be unable to tolerate certain lotions or skin care products. On the other hand, those with tactile discrimination disorder and interoception discrimination disorder may not notice cracked or bleeding skin.

Tips and Tricks:

  • Avoid clothing made out of bulky or scratchy materials like wool. Stick to soft, comfortable layers of fleece, cotton, or flannel, and remember to remove the tags!
  • Have your child try on and approve every piece of outdoor gear―coats, hats, gloves, you name it. If you can, buy extras of smaller items in case something gets lost.
  • Find alternatives to uncomfortable items. Experiment with earmuffs instead of hats, hand warmers instead of gloves, or snowboarding pants instead of snow bibs.
  • Apply moisturizer frequently, especially after bathing. If your avoider can’t stand lotion, experiment with body bars, coconut oil, shea butter, or aloe vera gel.
  • Stay hydrated by drinking water throughout the day. Add fruit slices, flavor packets, or seltzer to combat flavor fatigue.

Challenge #3 – Sensitivity to Cold and Heat

Not everyone experiences the sensations of winter in the same way. Tactile avoiders may feel unbearably cold while playing outside or uncomfortably hot in certain types of clothing. On the other hand, tactile seekers may love to play outside on very cold days, hold snow in their bare hands, or take extremely hot showers. Finally, those with tactile discrimination disorder and interoception discrimination disorder may be unable to feel extreme temperatures at all, making them susceptible to frostbite or overheating.

Tips and Tricks:

  • Check in with your child frequently, especially during outdoor play, to make sure he’s not become overheated or becoming too cold.
  • Ease your child into the colder temperatures. Use indoor sensory bins to help him get used to the texture and cold of ice and snow.
  • Be mindful of seeking behavior around extreme cold. Put time limits on outdoor play and make sure gloves, hats, and coats are being worn.
  • Combat feeling cold by taking warm baths, heating up towels or clothes in the dryer prior to dressing, and making hot chocolate after playing outside.

Challenge #4 – New Foods and Smells

For most of us, winter means tweaking our diets to include more hot and multi-textured meals like stews, soups, and crockpot dishes. Many fruits and vegetables are out of season and will have a significantly different taste or texture than they do in the spring and summer. All of these changes can be extremely upsetting to gustatory avoiders and tactile avoiders. In addition to struggling with new foods, olfactory avoiders may be bothered by cleaning, cooking, and other household smells they might not notice when the windows are open.

Tips and Tricks:

  • Introduce new foods slowly and methodically. See our previous article for a step-by-step guide.
  • Have your child help plan and prepare meals. This will get him familiar with new smells, textures, and ingredients without having to taste them.
  • Know your child’s favorite foods and have a way to make them inside. For example, you might buy a George Foreman grill or grill pan to make burgers or hot dogs.
  • Be conscious of cleaning, cooking, and other strong or unpleasant household smells. Open the windows when possible and keep the house well-ventilated.

Challenge #5 – Staying Active

We all have different reactions to being cooped up inside on a cold winter day. Vestibular seekers and proprioceptive seekers may become manic and start bouncing off the walls, while vestibular avoiders and proprioceptive avoiders may become withdrawn and almost completely sedentary. No matter whether your child is seeking or avoiding, engaging in regular physical activity is critical for relieving anxiety, improving concentration, and transitioning between activities.

Tips and Tricks:

  • Schedule times throughout the day to do jumping jacks, stretch, or run in place. This can be especially helpful when transitioning into a new activity.
  • Have a designated area of the house where “rough” play is okay. Include things like pillow forts, obstacle courses, and crash pads, trampolines, etc.
  • Play family games that involve lots of movement, such as Twister, I Can Do That!, and The Floor Is Lava!
  • Have your child help with chores that involve executive functioning and proprioceptive input, such as snow shoveling and carrying groceries or laundry.
  • Experiment with different seating options that increase movement and concentration, such as yoga balls, foam rollers, and balance beams.

Combat boredom by bringing tents, pool toys, and other outdoor equipment inside. Experiment with alternatives to outdoor games, like the Hover Soccer Ball.

Challenge #6 – Changes in Routine

Like any significant disruption, the changes in routine brought on by winter break can be difficult for children with special needs. Without external timekeeping cues such as what class they’re in or where the sun is in the sky, children with interoception discrimination disorder often have difficulty knowing when to eat, when to sleep, and when they need to use the restroom. 

Tips and Tricks:

  • Prepare your child for any changes in routine. What exactly will be changing? What will stay the same? Are there new cues can he look for to know what to do next?
  • Set timers or alarms throughout the day to remind your child when it’s time to eat, use the restroom, or shift to another activity.
  • See our article for building good transition habits for more tips on establishing routines, creating rituals, and managing expectations.