Monday, December 14, 2009

Asperger’s: The Itchy Tag Effect

Most of us familiar with the basic symptoms associated with Asperger Disorder understand that people with Asperger’s often seem hypersensitive. Children with Asperger’s today often readily voice their discomfort with textures, noises and scents they find uncomfortable, and this discomfort has become, if not an accepted diagnostic criteria, a very familiar phenomenon for parents.

In their April, 2009 article Talent in Autism, Simon Baron-Cohen et al. describe sensory hypersensitivity, a form of enhanced perceptual functioning typical of many individuals with autism spectrum conditions (ASC). Indeed, the article states that “studies using questionnaires such as the sensory profile have revealed sensory abnormalities in over 90per cent of children with ASC.” How individuals process information (both cognitive and sensory) may be highly impacted, even organized according to, these differences: and the differences may cause distress, but also predispose to unusual talent.

In my practice, adults with Asperger's frequently report highly sensitive senses of taste, touch, hearing, sight and smell. Sensory oversensitivities often reported by adults with Asperger’s include:

oversensitivity can cause the individual to feel physical sensations such as light touch, itchy fabrics, hugs and bare feet as unbearable.

Visual: oversensitivity can cause the individual to find fluorescent lights, bright sunlight, flashing lights and overly stimulating visual environments (e.g. casinos) to cause great discomfort.

Auditory: oversensitivity can cause the individual to find auditory input to be impossible to ignore. Foreground and background noises can compete with one another, leaving the listener unable to selectively attend. Shrill or high pitched noises, such as those of dental drills, children’s squeals or shrieks, and blenders can cause extreme discomfort. Discordant music can cause discomfort.

oversensitivity can cause the individual to feel uncomfortable with new tastes, or to find them intolerable. Children with gustational oversensitivity can prefer the same foods over and over again, refusing new foods and finding new flavors distressing.

Olfaction: Current research does not support evidence of oversensitivity for the sense of smell.

Clinicians who work with adults with Asperger’s often find that this sensory hyperacuity has been coped with and channeled in creative ways. Following are some of the positive coping mechanisms reported to me by clients who have struggled with sensory oversensitivity without knowing exactly what the problem was.

Clients who struggle with tactile hypersensitivity often:
• Wear soft, heavily washed, loose-fitting clothing, such as t-shirts and baggy shorts
• Avoid body piercings and tattoos
• Find showering unpleasant due to oversensitivity to sensations of water and changes in temperature
• Remove tags from clothing, which can be itchy
• Choose specific brands of clothing, underwear and shoes which provide minimal restriction
• Find ways to gain tactile input which is soothing, such as hair-pulling, hair twirling, hand tapping, etc.
• Enjoy stroking soft materials, such as the fur of cats

Clients who struggle with visual hypersensitivity often:
• Avoid visually overwhelming environments
• Wear sunglasses or hats to minimize bright lights
• Remove lamps or bulbs in work areas to reduce glare
• Cover fluorescent lights
• Close blinds during work time to prevent interruption by visual stimuli such as passers-by
• Keep work areas neatly organized to prevent becoming visually overstimulated
• Find visually predictable environments, such as video games, rewarding and comfortable

Clients with auditory oversensitivity often:
• “Tune out” when conversation becomes too overwhelming to attend to
• Avoid interacting in crowded settings, such as parties, or use substances to mediate oversensitivity
• Rely on electronics, such as iPods, to provide predictable auditory stimulation
• Wear noise-cancelling headphones when concentrating or meditating
• Spend quiet, solitary time to “recover” from overstimulating experiences
• Avoid telephone and cell phone use to minimize unanticipated auditory input
• Hum, sing or make noises to cancel out noises beyond individual’s control
• Listen to music excessively

If you have noticed your own or a loved one’s sensory hypersensitivity, be sure and treat it as condition to take seriously. Some researchers (see Belmonte et al., 2004) hypothesize that this sensory “magnification” may result from neural overconnectivity in sensory parts of the cerebral cortex. While research on brain structure and development differences is still being conducted, sensory oversensitivity in adults with ASC is well documented, and is most likely physiologically based.

Implementing some simple interventions can help the individual with Asperger’s feel much more comfortable in the world. An increase in sensory comfort can have drastic effects on cognition, avoidance behaviors and the ability to attend to other stimuli. Many of my clients report irregular sleep/wake cycles, with much “down time” spent recovering from situations which cause sensory overload. Taking care of yourself ahead of time when facing a sensory challenging setting can prevent “sensory hangover”, and is part of taking care of yourself.

Stay tuned for more on how sensory oversensitivity may be a contributing factor to talent and giftedness so often seen in adults with Asperger’s.


Loco Geologo said...

Great artricle. My hearing has always been overseneitive; even with hearing imparment.

Life needs to be quite and still. It would be better for everyone.

Anonymous said...

i agree that quiet and stillness can help. i cannot stand the level of noise in ordinary environments like work. it drives me insane. actually too much silence does, too - i prefer pink floyd!!

Andrew said...

I like routines. Even my job has routines. That helps me every day.

Michelle said...

Interesting that there is no evidence supporting oversensitivity to smell.

My son and I have both been diagnosed with Asperger's as well as ADHD.
I am very sensitive to tactile, visual, and auditory overstimulation, but also have EXTREMELY keen sense of taste and smell.
My son, on the other hand, has issues with tactile and auditory overstimulation, as well as gustation and olfactory. In particular, he absolutely DETESTS fruit. Most fruit he has never tasted in his life, or has violently refused since the age of two. He will often have a meltdown just smelling fruit from the next room. I don't know if this would qualify as olfactory overstimulation but his psychiatrist has diagnosed a phobia of fruit.


A very interesting article. Some symptoms I recognize and experience the sensations described, other symptoms do not affect me personally. The explosions in my mind aspie are always the result of sensory overload. So frequent periods of isolation need to stop mental activity caused. Sincerely ......

Anonymous said...

what about textures- meaning physical textures that have odd arrangements? Like taking a hammer to oysters growing on rocks because of the way they cluster together? Or funneled spider webs? Strange groupings? Hornet nests? Fungi?

Anonymous said...

Fantastic article. I have forwarded this to friends and family so they might understand why I have all of my blinds covered and stop talking every time it gets noisy outside.

I too was surprised by the fact that smell wasn't considered a factor. If I'm not eating and someone brings food into the room, I find it as unpleasant and distracting as having two people talk to me at once.

Cary Terra, M.A., LMFT said...

Wow - thanks south for your feedback. You don't hear much about smell, but it's such a problem for many of my patients. And the sens

Polishedteapot said...

I'm a 30 year old Aspie woman in Britain (no official diagnosis but spotted by my counsellor when having help after a traumatic birth as she had a special interest in the area). I am hypersensitive. I cannot stand two people talking

Polishedteapot said... once. I get upset by music (I am also synaesthetic) and can't stand to listen to other people's choices. I often eat the same thing time and time again. I have to shower in a darkened room when it is all too much for me. I am often afraid of crowded places like markets as I know they often lead me to meltdown. My AS is quite mild, as is my husband's. I am watching our 1 year old daughter like a hawk - no sign of AS so far.
I am now a SAHM and I love it. I used to be a teacher. Try getting 35 teenagers to understand only one person may speak!
Thank you for your blog.

Anonymous said...

29 year old TAG Aspie with severe sensory processing disorder. I sucked my thumb, hair pulled and used my blanket edge as a textile 'over stimulant' to help control the other stimuli that bothered me until I was 14 years old - I had no friends so it wasn't a big deal lol. Now that I am married to a man who totally understands me and turns off the fan when he sees me wincing in pain from the noise I have gone back to using a blanket - I have it with me at home almost all of the time and I use it when I drive, I don't stick my thumb in my mouth but there is always something about my environment that is hurting me - whether it be a sound, sensation, vestibular issue or smell that is causing me pain - I run the blanket edge across my skin and it provides a different sensation for me to focus on, it is by no means a perfect fix, I am still bothered by whatever sensation it is that is causing the problem but it does reduce the amount of discomfort it is causing..I guess sometimes over stimulation by a familiar comfortable sensation can help lessen the effects of the uncomfortable sensation. I hope this post helps someone else..also my comfort object allows me to function better in daily life: I use it on my way to the restaurant (or insert other uncomfortable situation here) then during the uncomfortable time if things get too bad I will think - I can have it back in just a little bit - and when I get back to the car or home I use it to help me wind down and calm down. Most days for Aspies like me with severe sensory problems are very difficult to get through, I feel like I am going to explode more than 50% of the time so if you can find something that makes you feel just a little better - use it and tell the world to deal with it if it's something like a 30 year old woman carrying around a baby blanket without the baby.

Anonymous said...

I also get olfactory over-acuity, but it is temporary, I think it may relate to hormones? Anyhow, I cannot *stand* to be in grocery stores at that time, as conflicting smells, even smells from food in sealed packages, overwhelm me and make me feel sick. Like eating chips, laundry detergent, and lemons at the same time because they are all within smelling distance as you pass by a corner.

Ine said...

Almost all artificial scents set my teeth on edge. Walking past the perfume counter in a department store makes me nauseous. I can only tolerate very specific types of deodorant and once even jokingly accused my boyfriend of cheating on me because I smelled something different every time I hugged him... until I noticed it was coming from my own armpits since my regular deodorant was out of stock. The smell of vinegar makes me nauseous too, I can't eat pickles or even ketchup because the smell hits me from 6 feet off. I use pleasing scents like a stimming tool, like coffee grounds or fresh flowers or herbs. Even plain water has a very pleasing metallic smell (not the chlorinated water in the US though). I could go on and on. I'm surprised olfactory oversensitivity isn't a thing.

Unknown said...

I am a Norwegian woman With aspergers, and I have a sentitivity towards too snug clothes, wool, noise, smells (I have very good smell sence), too much light and so on.

Anonymous said...

Totally agree with those who have extreme sensitivity to smells - especially artificial chemicals: perfumes, makeup, hair spray, air fresheners, insect sprays, paints, cleaners, detergents, artificial & treated carpets, upholstery - the list goes on & on. They make me feel ill and I cannot concentrate in the presence of them. Also very sensitive to pain - not mentioned here?

Anonymous said...

my son cannot stand the sound of someone whistling or the sound of someone clicking a pen. Can anyone give him any tips on this for him to cope in college. He also does not like the feel of tags in clothes and after showering he says he is really itchy. I would love to hear from other people with Asperger's who have these sensitivities and ways they cope

Anonymous said...

For what it is worth, my Aspie girlfriend very definitely has hypersensitive sense of smell. She smells layers to odors like dogs are supposed to. Walking through the mall, she can smell women that are menstruating from 20 feet away. Everyone has a smell to her. She is even very sensitive to her own odor, and sometimes cannot understand "how I can stand to be near her" when I smell is mild and not unpleasant.

Anyway, FWIW.


Lady Jane said...

i, too, get itchy after a shower. Using a lotion soap helps, also, getting my friend to massage me with a soothing oil or lotion all over my body.

I have learned to avoid sitting on upholstered furniture because it makes me itchy. And I strip my clothes and wash them right away at the end of the day and bathe or shower before going to bed or even sitting on the bed to avoid transferring any irritating pollen, fleas, dust, fibers, or other irritants onto the bed; otherwise I would not be able to sleep all night!

Anonymous said...

it's good to read, that other people have so many sensory issues too...well, i'd rather not have them and i guess you would feel better without them too, but sometimes i just feel like i'm the weirdest person in the world, because no one around me can understand these issues. i'm not diagnosed yet, but hope to be soon. autism/asperger just matches with all the problems i'm struggling with my whole life (i'm 31 now).
i have them all. smell is super terrible. especially after moving to the usa, new york. in the summer heat it smells like garbage everywhere. people smell from their deodorants, sweat. i even smell when people are sick or didn't drink enough. i get migraines when i pass the perfume section in department stores. i lived in japan for some months and i was so pleased to find lots of lotions, detergents, body soap and shampoos without smell or with a really "soft" smell.
taste can be very unpleasent, too. i remember times in university when they had slightly moldy (or whatever happened to it) rice. everyone was eating it at the cafeteria, i almost threw up at the first bite.
i can't remember leaving tags in clothes at all.
since living in new york, i can't sleep. the air conditioners from across the street/other apartments are way too loud.even with headphones on...then there is also a humming street light outside. sometimes i try to hide in the bathroom at night to escape it.
showering is no fun either. the sensation of the water is terrible. and then afterwards the skin is itchy. worst is washing my hair. first the sensation of the wet hair when leaving the shower. then blow drying. the noise and the dry, warm thank you. if i can avoid it, i do so.
groups of people speaking and i should take part in the conversation? all i hear is a bee hive. no way my mind can untangle all the different words.
visual...i can not look at heavily striped things too well for example. like closed blinds when the light shines through from the outside. i get dizzy and nautious. also when it's too bright, i definitely need sunglasses.
...just to name a few things, the lists go on and on. it's so distressing...for me and my husband who so often has to deal with his overwhelmed wife. sometimes i feel like a misbehaving child, because i start crying suddenly when we go shopping or whatever. it's just to much.
i hope to get therapy that helps me deal with these things soon.

Anonymous said...

I have often struggled to comprehend why tags bother me so much. I have often avoided wearing lace bras because the fabric irritated me so much, I could not concentrate on anything. I fear large crowds and interacting with people. I often tune out conversations when they don't interest me and many noises over stimulate me. I can't stand bathrooms fans and the cheering noise of fans at football games. I have never been diagnosed, but often wondered. I used to get overstimulated as a child and have complete meltdowns. Any suggestions of what category I fall under?

Anonymous said...

i am so glad i found this.
I suffer from severe anxiety (as well as bipolar)and the only things that calm me are water, stroking a cat and the vibration of a cat purring.
I have had a severe phobia of fruit since i was a baby, i cant stand watching or hearing people eat fruit, the smell mags me gag, if i tough fruit i cant get the repulsive crawling sensation away and have to scrap my fingers of rough bricks of similar surfaces.I get angry and upset when i am around it and can even start crying.People talking about it upsets me and gives my body creeps.I cannot have it in my house and watch the movement of where and whats its touched like its a contamination.
I go through stages of severe anxiety about any insects which could possible touch me as i can already feel that feeling of what it would feel like.
I crave extreem loud music ( naturally only music I like)and feel as though it is literally passing through my entire body and consuming me.Could Aspergers explain this?

Ash said...

Just READING the title had my skin crawling! Evil tags...

I actually intend to skip the formal ASD diagnosis and go straight to the SPD one first.

And of course, there are those who also have hyposensitive senses. I love me some crunchy stuff and it's hard for me to keep my moods balanced without regular muscle tension like exercise. Lots of autistics are known for chewing stuff too.

Mo said...

I have that! It's called trypophobia. Whatever you do do not Google image search it.

Mo said...

I have that! It's called trypophobia. Whatever you do do not Google image search it.

Anonymous said...

I'm a 50 year old Aspie with ADD. I am oversensitive to everything (Tactile, Visual, Auditory, Gustation, and Olfaction). Current research doesn't support evidence of Olfaction oversensitivity, but I believe it's just a matter of time until they do. It's definitely there for me.

Aspie girl said...

My sense of smell is lousy, but my sense of taste is so over developed and sensitive that I can't stand anything slightly spicy. Even tomato sauce seems a bit spicy. I can't stand chocolate or candy because for me, it would be like eating sugar and syrup mixed with honey.

I can only wear crocs or sandals, and as a result, I keep getting sand under my feet, and it's like sandpaper to me, even when the speck of sand is too small to be seen, but I can feel it with my oversensitive fingertips.

Leonie Cent said...

Hi all, i have a blankly which i don’t wash regularly so it starts smelling quite strong after a while. I’ve had it since a baby and never gave it up. (I’m 53 now). Sometimes I suck my thumb but mostly like sniffing it and feeling the sensation of it under my nose or in my hand. I liked the article, but get annoyed by the fact that some articles like this always refer to parents and children with ASD. What about adults? Thank you.