A Simple Strategy for Overcoming Resistance in a Child with Autism

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I worked with a young mom recently who came to me exasperated by her daughter’s refusal to wash her hands and dry them or sometimes have a meltdown when the mom would do this task for her. The mom was at her wit’s end and having tried many ways to make her daughter comply she resorted to punishment and loss of privileges as a last resort.

It turned out that there was an easy solution to this problem behavior but one that the parent had never even considered – she didn’t even think it was in the realm of possibilities. Why? Because when I asked this mom if her child had any sensory issues she said, “No, they ruled out the diagnosis of a Sensory Processing Disorder (SPD).”

There are many children, on and off the spectrum, that are diagnosed with SPD and the Sensory Processing Disorder Foundation places the estimate of affected children at about one in 20 children. Individuals who have sensory issues have brains that are wired in such a way that it is difficult for them to accurately filter the sensory information that is coming in. Either the brain reads the sensory input as way too much or way too little. If a child has significant impairment in this area they earn the label of SPD.

But what if the impairment is not severe enough?

Can such a child still have sensory issues?

The answer is yes.

Children with sensory sensitivities can be hyper or hypo sensitive to different types of visual input or certain touches, tastes, textures, smells and noises. I have known many children who:

  • will only wear clothes made of soft fabrics,
  • are particular about the seams in their socks and where they fall on their feet,
  • gag at the smell or texture of a certain food,
  • are overly sensitive to bright lights,
  • won’t sit on a cold, hard toilet seat
  • have difficulty concentrating due to the humming noise that florescent lights emit in a classroom.

In addition to these commonly know reactions that sensory issues can bring about there are many resistant behaviors that can be triggered by a particular sensory challenge, especially if your child is on the Autism spectrum. Your child may not have full-blown SPD yet he or she may be sensitive enough to various stimuli that it will affect his or her behavior in a negative way.

So if your child does not meet the criteria for SPD don’t rule out the presence of sensory sensitivities. Just because your senses can tolerate a certain stimuli it is possible that the same experience can assault one or more of your child’s senses.

That’s right, there may be a simple reason why your child resists certain activities or refuses to cooperate. Your child may not be behaving badly – his behavior might simply be a result of a sensory sensitivity.

When you have a child that is challenged in this way, a simple sound, taste, smell or touch can send them over the top. You may find them refusing to do certain tasks or rejecting activities that seem so simple to us. As a parent it is sometimes all to easy to judge this behavior as willful, stubborn and resistant, especially when we look at it through the lens of our own experience and perspective.

Behaviors can be very baffling to parents, which is why you need to examine them through the lens that your child experiences the world with because most likely it is very foreign to our own. Once you identify and understand that the behavior is triggered by an over reaction to sensory input it becomes easier to address.

As in the scenario of the mom and little girl that I introduced above, it turned out that this young lady had a sensory aversion to the touch of a wet, slippery, squishy bar of soap, therefore she resisted touching it unless the bar of soap was dry and firm. Also, the texture of the towels seemed to be a turn off for her and even though this little girl was not Goldilocks finding a towel that was ‘not too hard, not too soft – but just right’ was the key to turning her behavior around.

Once mom switched to a liquid soap that her daughter helped pick out in order to make sure the smell would be agreeable to her – just in case her overly sensitive nose was part of the problem – and mom began to use non-scented fabric softener and dry the towels in the dryer as opposed to line drying them, her daughter had no objection to washing her hands.

I help many parents create sensory-friendly environments that can enhance a child’s level of cooperation and reduce negative outbursts. In this particular story, the behavior was resolved in an uncomplicated fashion. Unfortunately, the solution is not always this simple but the outcome can be just as positive especially when a parent is willing to think outside the box and see things from their child’s point of view.

If your child displays a behavior that baffles you, consider the possibility of a sensory issue at play. Remember, your child does not have to have a Sensory Processing Disorder in order to have an extreme sensory reaction to something. Many of us can relate to the awful feeling that fingernails down a blackboard can produce in us. If you can accept this as an understandable reaction in yourself all you have to do is stretch your imagination a bit and accept the fact that something else less typical can have a similar effect on your child.

How do you determine if your child has a unique sensory challenge? Please add your comments below.

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Comments

  1. abby says:

    kindly help my son who’s sensory processing disorder persistent of his oral phase. finds pleasure plastic objects. cannot distinguish food from electrical wires, sadly even feces and his own urine. when frustrated because he is non-verbal jumps and land high impact with his cross legs. has a high tolerance to pain.please help us. help my son.

  2. andrea says:

    first question would be can you clean the rust off of it. if that’s not possible how about painting it. , would that help? if neither of those is an option then I would tell your husband that it needs to go.

  3. Connie says:

    Abby,

    Does your son see an Occupational Therapist? It sounds like he may have pica, the persistent craving and compulsive eating of nonfood substances, a very common issue among kids with neurological disorders, including autism spectrum disorders. You may want to check out this wonderful guest post Bobbie Sheanan and Dr. Kathy DeOrnellas, authors of What I Wish I’d Known About Raising a Child With Autism, wrote called Let’s Talk About Pica http://parentcoachingforautism.com/2011/12/autism-and-pica/
    It also sounds as if your son is sensory seeking, as if his body needs the intensity of jumping and falling for the sensation to be registered in his brain. I would encourage jumping but in a safe manner – trampoline, cushions, hopscotch, hopping/sack races, etc. I assume you have spoken to his doctor about his high tolerance to pain and what might be an issue with his pain receptors not working properly. This is a safety issue that needs to be addressed. I hope this is helpful.

  4. Connie says:

    Andrea – Thanks for your interest and advice in trying to help me : ) I appreciate the response. We are currently in the negotiating stage of how to resolve this. I did suggest painting it but he said it would ‘cover up it’s beauty’. Stay tuned!

  5. Kathi Blacker says:

    Hi Connie,
    Couple quick answers….
    1) husband item…does he have a ‘man cave’? or your place have a basement? That would be the place I would suggest it go…in a location that you do not frequent often, or out of your view of travelling in his space/pace. My husband is a ‘collector’ of many things, so this compromise works well for us–I totally understand maintaining the ‘integrity’ of an item–I like ‘antiques with character’–which translates into ‘original state’.

    2) Yes, OT input would be helpful; but with economic times and cutbacks in education, sometimes this avenue is not accessible…SO…….from an experienced teacher, the ‘jump high & land hard’ may be replaced by the safe jumping ideas–or find an old-fashioned spring style horse for jumping & rocking on–plus learning to do ‘joint compressions’ on your child, and finally, using weighted materials–blanket, vest, backpack, wrist or ankle weights–or even 1/2 gal plastic jugs filled with water or rice (& cap hot glued on) to carry around. (water weighs 8# per gallon, so 1/2 gal = 4#…rice is easy to weigh–just get the 1# packages & add up to what is comfortable for child). In my experience, ‘adding weight’ to the child helps because these things are giving a clear message to the child’s body & brain that it is ‘grounded’. It is only theraputic & helpful if the child seems calm & accepting when you try it–but it may take several trials to find out what area of body and type of weight is most accepted by your child–in case of ‘jumpers’, usually easiest to start with ankle weights &/or a veight vest or jacket (rice or fish gravel ‘bags) in closed pockets—as it ‘weights shoulders’, it keeps feet on floor–”grounding” the bottoms of the feet comfortably on a solid surface continuously (that is the sensory theory for doing it). This is quick, but hopefully helpful–and a starating point perhaps for trying to get an OT enlisted for your child…from your school or physician referral, or even health department?

  6. LALITH SHAMSHIR SHAMSUL says:

    Hi Connie, thanks for the wonderful article. My son is 5 yrs 8mths old. He screams when called to take a bath. My wife does this everymorning and our maid does it in the evening. Both times he will scream. Even worse if he has to brush his teeth. Everytime my wife tries to brush his teeth in the morning, same scream. However, he loves playing with water. He will willingly go to the bathroom and bring his toys to play with a bucket of water in the bathroom. His clothes will get wet and he doesnt mind. Sometimes, he will remove his shorts when it gets wet. Otherwise he’d love playing water. Similarly i can hose him down in the garden and he’d love it. In fact we have difficulty stopping playing water games. But bring him to the bathroom to bathe and he’ll scream. Not just this bathroom, even my mother’s house, my brother’s house or anyone’s bathroom. Its baffled me and the missus. Any and all help is greatly appreciated. Thanks in advance

  7. Connie says:

    Great idea Kathi – he does have a man cave of sorts, the rusty turtle would be perfect for that, at least I think so : )
    Thank you for the other wonderful OT suggestions that I am sure Abby appreciates as well. These are great activities to expand her son’s sensory diet that will address the jumping issue.

  8. Connie says:

    Lalith – It does sound like you have a bathtub dilemma but there is a solution to it, you just haven’t found it yet. I suggest you continue to gather as much information about his resistance as possible in order to detect the trigger. Until then make your bathroom/bathtub as user friendly and sensory friendly as possible. Is the tub slippery and he fears being off balance – a bath mat might help? What if you placed the bucket of water in the dry bathtub? Begin with having him stand outside the tub while playing in it then gradually see if you can entice him to get into the tub with the bucket etc. This is a gradual way to introduce the bathtub in a positive light that might work. I have many other ideas but would need more information first. Best of luck!

  9. John says:

    Hi Connie,

    My daughter Gemma, 16 years old with ASD, was at a young age diagnosed with also having hyperacusis. Gemma went to a sound-learning centre for a 10-day course where she listened to filtered music through headphones and this helped her a lot. Steadily over the years she has slowly gone back to how she was again with certain noises causing her to have tantrums and biting herself. The most common noises are car horns, telephones ringing, dogs barking, certain coughs, doorbells etc. I took her to our local hospital to see about a filtered hearing aid as she is now living in ear defenders. The consultant carried out a hearing test and told us that it wasn’t hyperacusis but more a learned fear of noises themselves. It seems to be mostly sudden noises that Gemma wouldn’t expect.

    Please could you suggest any way that I could help her?

  10. Connie says:

    Maybe your daughter could use another dose of listening therapy? Wearing “ear defenders” all the time does solve the problem but is not very realistic. If this is a learned behavior, it can be unlearned as well. Other options might be to gradually desensitize your daughter to the sounds she fears. The best way to do this is to have some kind of recording device or smart phone where you can record the sound. Then choose a time when you are at home and your daughter is not anxious and feeling secure and play the sound at a very low volume. And then have your daughter increase the volume a little bit at a time. Make sure the volume is under her control and continue each time you do this to increase it until you get it up to the expected volume. Let me know if you need more specific details on how to do this.

  11. John says:

    Thank you so much for your time and your advice. I’ll try to gradually desensitze as you suggest and will let you know how we get on.

    I’ll be so pleased if this has a positive effect for her. Thank you again.

  12. Connie says:

    John,
    You are welcome and please do let me know what the results are. Every child is different and will respond differently but with the limited information I had this was my first suggestion. Think positive!

  13. Heather says:

    Great article! We’re STILLLLLLLLL toilet training Reena. (THANK YOU for all of your help in toilet training Chananiah!). She’ll be 6 in January and is successful when we take her on a schedule. If we veer from the schedule a tad, or she drinks more than normal, she has #1 accidents. She never self initiates. She LIKES the feeling. She still NEVER puts #2 in the toilet either. Our local center for autism has suggested a cold shower for every #2 “accident” to pair the accident with something aversive— we spoke to Deb Bialer about that, the author of “Teach Toileting”, and she said that it’s probably best to focus on getting her to self initiate getting to the toilet for #1 first rather than worry about #2 now too, since she usually makes #2 in her nighttime pullup, hoping to sleep all night in it.

    So I’m reading your article about resistance and how it can relate to a sensory dysfunction and it’s making sense for me in other areas of Reena’s life….. she’s a total sensory seeker and WANTS the feeling of her waste on her bottom……. of COURSE she’s resisting #2 on the toilet—– so often she waits until bedtime after she’s in her room in her nighttime pullup to go #2. Sitting her on the toilet before bed just produces a massive meltdown– she withholds, and it’s a waste. What are your thoughts—- focus on getting her to self initiate #1 even if it takes another year and forget #2 for now? Or try to poop train now as well, and how? Waking her up during the night isn’t aversive enough for her– she goes right back to sleep. Taking away priveliges for poop in daytime underwear doesn’t work either.

    I thought pee training Chananiah would be the hardest part of toilet training these twins with autism but man Reena is giving me a SUPER run for my money. Meanwhile Chananiah is doing great, self initiating both #1 and #2 these days.

  14. Connie says:

    It probably is a sensory issue for her and I have other thoughts as well Heather but I need more info. I would love to chat. How about a complimentary 15 minute consultation call? Just go here to schedule a time that is convenient for you. https://my.timedriver.com/MFCXL

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