Leading on from my previous post about autism and sound sensitivity, this week I’d like to take a look at auditory processing disorder or APD.
So what exactly is APD?
APD, also known as central auditory processing disorder (CAPD), is a condition where a person doesn’t fully process the sounds they are hearing. There is generally nothing wrong with your hearing ability, but a neurological issue in interpreting the meaning of that sound. People with APD often struggle to understand spoken instructions, sentences where they’ve missed words, thick accents, words that sound similar, and understanding conversations that place in noisy environments. For example, if someone said the word ‘dog’, you would hear the word perfectly, but might struggle to retrieve the meaning of the word.
So how is APD linked to autism?
APD’s are very common in autists, but the link is unclear. One of the leading theories however is that the hippocampus is immature and underdeveloped in the autistic brain. This part of the brain is responsible for processing auditory and other sensory information, so if the region is not properly developed, autists will struggle to process sensory input like sound. Other research suggests that autists are hearing and processing sound properly, however, they are processing this information at a slower level than their peers due to delayed development of the auditory cortex in the brain.
An interesting behavioural study proposed that autists are actually processing sounds correctly, however, they are choosing to not pay attention to certain sounds or speech due to variations in their attention span.
Some researchers have also linked difficulties in auditory processing to impairment and delays in language development in autism as the ability to process sound efficiently is critical to language formation.
To help autists struggling with APD to better process sound, it’s recommended that you:
Leading on from my previous post about sound sensitivity, this week I’d like to explore the subject of noise reducing earplugs. In recent weeks, I’ve been getting a lot of Facebook ad’s for noise reduction earplugs, so I finally decided to take the plunge and buy a pair to see what all the fuss is about.
So how exactly do these noise reduction earplugs work? Isn’t the whole function of earplugs to reduce noise anyway?
Noise reducing earplugs are different to your garden variety earplug in that they are designed to reduce background noise without compromising audio quality in your immediate surroundings. Most earplugs will muffle sounds, but this next generation of earplugs focus on filtering them instead of blocking them. There are a lot of different models out there at the mo, but I chose to test drive Loop Earplugs. Loop are designed with an acoustic channel in the earplug to mimic the auditory canal in your ear, and use a mesh filter to reduce the volume of your surroundings. They are particularly designed with concerts in mind, as music is often played above safe levels (85 decibels) which can permanently damage eardrums in as little as 15 minutes. They have a couple of audio reduction levels from as high as 27 decibels down to 18 (which I tried) so you can purchase whatever reduction level suits your needs.
So how did I find them?
This weekend, I tested them out on a busy day in the noisy city of Dublin. I popped them in while walking down the street and found it really did reduce the sounds around me, but I could still hear everything I needed to, such as the noises from pedestrian crossings. As I was attending a musical, I also gave them a test run in the theatre for a couple of songs. I was really surprised at the results as the songs were just as clear with the earplugs in and out, just different volume thresholds. Unlike other earplugs, the loop in the plug is quite cool, and looks like a trendy piercing in your ear, so it’s also great that you don’t feel self conscious for having awkward things sticking out of your ears (like those ugly yellow foamy ones they give you on airplanes).
However, while these filtered out a lot of background noise, they did amplify and alter some internal noises. My voice sounded really distant and far away like I was down a tunnel, but everyone around me sounded fine. While walking to the theatre I ate a Magnum ice cream, and as I ate, the earplugs increased the volume of the chocolate crunching in my mouth to unsettling levels, and I could hear my jaw clicking as the upper and lower jaws rubbed against each other. It really weirded me out so I would not recommend eating while wearing them! I also found they didn’t sit in my ear that well and kept popping out, but I do have smaller ears (or so I’m told) so it’s possible that my ears are just not built for earplugs! 😛
I would definitely recommend trying out these earplugs or similar models (there are some that are more geared specifically for noise sensitivities such as Calmer) if you need to turn the volume of your surroundings down a smidge- I will certainly be adding mine to my handbag for days when I find myself in an auditory nightmare.
So this week I wanted to briefly put together a post about some of the lesser known autistic traits. I’ve discussed most of these before, but I wanted to put them all in the one place 🙂
Fecal Smearing– yep, really diving in at the deep end on this one! 😛 As disgusting as this is to talk about, fecal smearing or scatolia, can be one of the earliest signs of autism. Reasons for smearing are generally thought to be either behavioural (attention seeking) or sensory. Scatolia in particular seems to be linked to periods of under-stimulation in autists and so the behaviour appeals on a textural and olfactory level… This is in actual fact a pretty common autistic behavaiour, but the vast majority of people are unaware of it- because let’s face it, who wants to talk about poo! 😛
Skin Picking– As we’ve previously discussed, skin picking, or neurotic excoriation, is a pretty common autistic behaviour (an estimated 14.8% of autists may exhibit this behaviour). Autists may pick, scratch and squeeze their skin as a physical expression of emotional/psychological distress to relieve their discomfort through self- stimulation.
Regulation of Tone– Another common but lesser known behaviour is that of autists’ struggles to regulate their tone of voice. Impairments in audio processing and prosody in the autistic brain can make it difficult for an autist to accurately gauge the tone and volume of their voice, so try not to judge too harshly if they accidentally shout in quiet conversation 🤫
Digestive Issues– Perhaps one of the most common but equally unknown challenges of autism is that of co-morbid digestive issues. Autists may be over 3.5 times more likely to suffer from issues such as diarrhea, constipation, food allergies, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and inflammatory bowel diseases (i.e. Crohn’s disease and ulcerative colitis)- the associated pain from which can exacerbate behavioural symptoms.
This week we’re going to talk about something that effects approximately 75% of autists- Echolalia.
I know, I know, it’s a mouthful- but echolalia is actually quite simple:
Echolalia is the meaningless repetition of noises, words or phrases immediately after their occurrence (although sometimes this can be delayed).
Derived from Greek echo, “to repeat,” and laliá, meaning “talk” or “speech,” Echolalia is an automatic and unintentional behaviour. In most cases Echolalia is used in an attempt to communicate, practice or even learn language. In fact, Echolalia is part of normal development- every child experiences Echolalia when they learn a spoken language.
However, whilst “normal”, this behaviour can persist for longer in autists.
But why might this be?
Psychologically speaking, Echolalia is considered by some to simply be a repetitive or self-stimulatory behaviour in autists (as some experience this behaviour only when they are stressed), however, the general school of thought is that it is a communicative behaviour. Imitative behaviour is an essential part of social learning. As autists struggle so much socially, this imitative behaviour can act as a tool to help improve their social skills.
I’ve certainly exhibited such imitative behaviour during my formative years. For example, I somehow got it into my head that in my final year of primary school I needed to practice my swearing so that I would better be able to fit in when I made the jump to secondary school! 😬🙈 Wasn’t especially successful- sure I could swear like a sailor, buuuuuut it didn’t do much to improve my social skills or status (but I suppose I sounded a little less like a walking thesaurus for a change! 😛 ).
On the biological side of things, much of the physiology of Echolalia remains to be explored, however, one study indicates that the ITGB3 gene (which carries the information for β3 integrin- a cell membrane protein that will interact with other proteins to trigger a number of biochemical reactions in our cells) seems to link autism and echolalia.
There we have it now Earthlings I hope you enjoyed this post! 🙂
Today we’re going to briefly talk about an aspect of the spectrum that many of you may not be familiar with- voice control.
We’re all aware that autism is often accompanied by difficulties with speech (non verbal autism, apraxia, speaking in monotones etc.) however, few are aware of the challenges to control the pitch and volume of our voices.
This is especially challenging for me as I often struggle to accurately gauge my volume. For example, I may think that I am singing along at an appropriate volume, buuuuuut those who are listening to me may have slightly different reactions…
I’ve probably deafened several members of my friends and family at this stage! 😛
For years I could never understand how I was chastised for my mumbling in school, but a shouter at home- I just could never seem to get the balance right.
I naturally tried to rationalize my shouting with waxy ears and struggles to be heard over the din of the school- but is there any scientific explanation for my struggles to regulate tone?
Many acoustic studies have found that prosody (an area of linguistics that focuses on linguistic functions such as tone, intonation, stress and rhythm of speech) is impaired in autists. Prosody is used to reflect emotional states, sarcasm, stress, emphasis and other areas of language that are not conveyed through grammar and vocabulary- an area where many autists struggle.
MRI studies have shown that the areas of the brain involved in the perception and processing of prosody (the left supramarginal gyrus (SMG)) are abnormally activated in autists compared to their neurotypical peers. Neurons in the left precuneus, the left medial prefrontal cortex and the right anterior cingulate cortex should be deactivated when exposed to prosody, however these areas are active in the autistic brain.
As a result, we are often unable to discern the exact pitch, tone or emphasis we should use in conversation. This abnormal activation also explains why autists often struggle to accurately interpret another persons meaning/intention through their use of prosody in their speech.
Impairments in auditory processing of sound in the brain may also feed into this issue- so try not to judge me too harshly the next time I blow your eardrums out 😬 😉
This week I’m going to discuss an important issue for many people on the spectrum- going to the dentist.
I know- no one ever really enjoys going to the dentist (except maybe Bill Murray in ‘Little Shop of Horrors‘! 😛 ), but for autists in particular, visits to the dentist can be quite traumatic. For many, the invasion of space can be an issue, for others, a trip to the dentist can aggravate sensory sensitivities (the sensation of brushing, the taste of toothpaste, the smell of latex gloves etc).
Thankfully I have never had any major issues with going to the dentist (aside from one unpleasant incident where the anesthetic didn’t take and I felt the drill hit a nerve…), nevertheless it wouldn’t be one of my favourite activities. The high pitched squeal of the tools, the scraping sensation against my teeth, the needles (shudder!)- it’s not the most pleasant of experiences inside my head! There’s a lot of fist clenching! 😛
So how might we navigate an autists difficulties at the dentist?
Here are just a few tips and tricks that might benefit parents, dentists and autists alike:
Inquire if your dentist is autism friendly– Have they had autistic patients before? Do they have any special tools or techniques to make the visit more comfortable? Do they take any sensory interventions such as dimming the lights, providing sunglasses or minimizing any loud noises that may startle the child?
Prepare for a dental visit– Help to desensitize an autist to the experience by story-boarding a trip to the dentist with them so that they know what to expect. When it comes to anxiety, the fear of the unknown is often greater than the reality of the experience. Why not inquire if your dentist will allow you to visit the surgery/send pictures to desensitize your child to the environment and meet the staff before coming in for the real thing? 🙂
Wear noise cancelling headphones– whilst this may not be as effective as in other situations given that the tools are operating so close to the ears, nevertheless this may help to take the edge off any noise related issues.
Weighted blanket– A weighted blanket sitting on your lap could be quite beneficial in calming an autist. As I’ve discussed previously, the deep pressure stimulation can calm the mind and put the autist at ease. X-ray jackets can also be used to substitute for a weighted blanket. Comforters such as soft toys or other sensory items that autists use to ‘stim‘ can also be useful to help put them at ease.
Communication is key– as I’ve said above, the unknown is often one of the more unsettling aspects of a dental visit for an autist. Talk them through each step, show them what you are planning to do to their teeth, allow them to see and feel the tools- testing a motion on the hand can be useful to desensitize an autist prior to the oral exam.
Rewards and Bribery– what child doesn’t love a good bribe to motivate them to get through their dental appointment?! There’s a lot to be said for the power and promise of a treat (I may have even bribed myself with a trip to the cinema to motivate me to get this post finished on time! 😂)
Sedation– though not the best of options, this can sometimes be the only way for particularly anxious autists or those with gagging issues to get through a visit to the dentist.
I’ve also found this useful video about visiting the dentist if you want to check it out:
You can also find more information in the following link:
So there we have it Earthlings! I hope you’ve found this post useful 🙂
Dental care isn’t always the easiest for an autist, but remember, prevention is always best- so get try to find a toothpaste that you like, pick the right toothbrush (soft bristles can be helpful) and take care of those pearly whites! 🙂
Leading on from my previous post on sensory processing, today I’m going to expand a little bit on sound sensitivity.
Many autists have a higher sensitivity to certain volume ranges and frequencies of different sounds. Also known as hyperacusis, this sound sensitivity can make encounters with seemingly innocuous every day noises a struggle.
For many, the wrong sound can even cause physical pain!
Sometimes autists can also be hyposensitive or under sensitive to sound, meaning that they may not react to certain sounds, or may even enjoy noisy environments- which would explain my preference for rock music 😛 😉
Luckily, I am only mildly sensitive to sounds, but I have my moments. Popping balloons, the unexpected blare of a drivers horn, a sudden change in the music I’m listening to- I may overreact to such sounds juuuuuust a teensy bit! 😛
I recently physically jumped at my desk after an unexpected change in the soundtrack to Phantom of the Opera!
Mortified! 😛
Sometimes it’s not just the volume of the noise, but the frequency or how it sounds to me. A person was recently whispering a rosary behind me at mass and the pitch of that whisper nearly drove me insane- inside my head I was silently screaming! 😛
A neurotypical may be able to ignore irritating noises like these, but I just cannot keep from focusing on it- it’s like I can’t concentrate on anything else.
For the most part I can keep my screams on the inside, but if a particular sound persists it can be quite upsetting, especially if I’m already stressed and on edge. A piece of lab equipment that kept backfiring with a giant pop one afternoon triggered a meltdown for example.
But why are our ears really so sensitive?
One study suggests that autists experience stronger autonomic reactions to noise (these are unconscious reactions triggered by the autonomic nervous system which controls a number of bodily functions such as heart rate, respiratory rate and digestion- i.e. “rest and digest”).
Another study, which examined the brains response to different sounds, found that certain areas are hyperactive in children with autism versus their peers. For example, there was increased activity in the Amygdala- an area of the brain associated with social and emotional behaviour, in addition to the cortices which process sensory information.
In other words, the autistic brain has an entirely different physiological response to sound!
So try to bear that in mind the next time you sneak up behind us to whisper in our ears! 😛 😉
Ah, live music! There’s nothing I love more than a decent rock concert!
“But wait- wutt?!
You’re autistic! Surely you can’t enjoy a loud, flashy, crowded rock concert?!”
Plleeeeeeeeeeeeeeease! 😛
What do I always say? No two autists are alike!!!!
Sure, sudden noises can make me jump, but in actual fact I love the noise! I relish the chaos of alternative rock! The vibration of the music through your body, the bright lights, the pyrotechnics, the showmanship- it’s really hard to beat a decent concert.
That being said, my love for gigs has not come without it’s challenges.
At my very first gig (Paramore’s Brand New Eyes tour, 2009), I suffered both a meltdown AND a shutdown! The crowd made me very unsettled and uncomfortable moshing during Paramore’s opening number, so I spent the remainder of the concert on the sidelines crying and alone! 😛 We subsequently almost missed our bus home, the stress from which brought on a shutdown.
Certainly a memorable and eventful night! 😛
Indeed, concerts can be overwhelming for both neurotypical and neurodiverse alike, but that does not mean that a concert can’t be an enjoyable experience. It’s all about finding what works for you 🙂
Here are my tips for finding comfort at a concert:
Outdoor vs indoor venues: This is one that I’m learning the hard way. Outdoor gigs, whilst a little easier on the ears than indoor venues, can be a real mixed bag in terms of enjoyment. Crowds are bigger, snagging a good vantage point can be tricky and security have far less control over crowd behaviour. I spent much of my last gig being kicked in the back by a girl sitting on her boyfriends shoulders. Take my advice- choose indoor gigs for your favourite artists.
Choose seating– After my first “pit” experience, I have made a point of always choosing to pay a few euros more for a decent seat in large arenas. This way you avoid strangers touching you, claustrophobia, tall people, reduce exposure to potentially unpleasant odours (outdoor gigs are a real pain if you hate smoking as I do) and prevent being unexpectedly hit by stray “balloons”, flying glasses of beer and, on one random occasion, black nail varnish! Don’t you just miss the emo kids of the mid noughties? 😛
Alternatively, if you’d rather be closer to the action, smaller venues (< 2000 capacity) generally offer more comfortable standing experiences. Crowds are spaced out more and are better behaved with security always close at hand 🙂
Sunglasses-Not as crazy as it sounds I promise! Sunglasses are my best friend as they really help to take the edge off bright lights. I’ve even been known to wear them on a night out in the club on occasion! Don’t worry about what other people think- it’ll be dark and everyone will be too focused on the stage to notice 🙂
Earplugs– This one may seem a little bit counter productive, but lot’s of people do it. Loud music is part and parcel when it comes to gigs, but sometimes the noise can be a little excessive. Take my most recent concert just last week. I was standing in front of a girl who insisted upon screaming every 5 seconds for 2 and a half hours- not like your average fangirl, but a murder victim (the kind of piercing scream that makes you jump every time you hear it)! Quite frankly, she’s lucky she wasn’t my murder victim! 😜😂 I was rather envious of a nearby concertgoer for having had the sense to bring a pair!
So there we have it, my top tips for managing autism at a gig!
As I always say, you should never allow an autism diagnosis to hold you back- if you can’t climb the mountain, there’s always a way around it 🙂
Ah the cinema- giant screens, surround sound, confectionery counters, reclining chairs; a perfect treat in many respects (until you need to dash for the loo, or eat too much sugar! 😛 ).
But for many people with autism, a trip to the cinema can present a number of sensory challenges- the brightness of the screen and overly loud audio can be quite distracting for example.
In recent years, a number of cinemas have begun to host special sensory screenings for children with autism.
In case you hadn’t noticed from all of the autism on screen posts I write, I’m a bit of a film buff, so naturally when I saw that my local cinema was hosting a sensory screening of ‘Diary of a Wimpy Kid: The Long Haul‘ I had to give it a try! 🙂
For anyone thinking of seeing the film, it’s not as good as the previous ones- the cast change didn’t really work! 😛
So what’s different about a sensory screening?
A sensory screening differs from the average cinema experience in the following ways:
A special sheet of acetate (it reminded me of a giant plastic pocket) appeared to cover the usual backdrop to reduce the screen brightness
There are no trailers (woohoo 😀 !)
Sound levels are reduced
The lights remain on throughout at a dimmed level
This last part was quite nice actually as I did not emerge from the cinema with the usual vampire-esque response to daylight! 😉
So what did I make of the experience?
Well, to be honest it was a little weird for me at first as someone who frequents the cinema quite regularly. I wasn’t expecting the lights to stay on, but you adapt pretty quickly. It was quite a pleasant transition to go from dark to light scenes without feeling blinded! 🙂
This did however, make it a little bit harder to see any of the night-time scenes which I found a tad distracting.
But all in all I found the experience quite nice and would highly recommend it for anyone who struggles with sensory issues 🙂
However, I would have a slight critique to make in the choice of sensory films that are shown. Any films that I have seen advertised as sensory friendly here in Ireland fall into the family friendly/childrens category. While it is brilliant that many children with autism are afforded the opportunity to attend these screenings, we often forget that children with autism grow into adults with autism, adults who may want to watch the latest Marvel or James Bond movie, or a racy rom com in sensory comfort.
So today I’m going to briefly introduce you to the issue of sensory processing for people on the spectrum. This is a very broad topic, but I’ll expand on the issues in more detail at a later stage 🙂
Many individuals on the autistic spectrum struggle to process every day sensory information. Sounds, textures, smells, lights, even colours (boys in particular struggle to process the colour yellow) can overload the nervous system and greatly upset us, effect our behavior or even trigger a meltdown.
But why?
In autism, our senses can be either hyper or hypo sensitive (sometimes even both) to stimuli at different times. Our senses are heightened- smells are stronger, sounds are louder. As a result of this, stimuli reverberate all the more intensely in our brains.
Think of the brain as a computer server at exam time where everyone is logging in at once. Too much information has been entered into the system, but the server can only cope with so much. The entire system becomes overwhelmed and the server crashes.
Here’s just a quick video simulation of sensory overload.
Warning for those on the spectrum– this video contains flashing lights, bright colours and loud, sudden noises
For me personally, I have many (mild) issues with sensory processing. Smells, tastes and textures are a daily struggle. For example, I don’t think I’ll ever be able to eat a salad as the smell alone makes me want to throw up- I’m dreading what pregnancy may one day bring! 😛 😉
Loud or irritating noises, (especially repetitive ones), too can be a challenge. Don’t get me started on the shock I get when a passing bus makes that giant hiss/woosh sound or a car honks the horn unexpectedly!! 😛
Most days, you’re lucky and the offending stimulus passes quickly, but other times it can get the better of you. I recently had a near meltdown on holiday from a cocktail of excessive heat, hunger, exhaustion and social frustration.
Top Tip– Keep on top of your hunger/thirst. I’ve discovered this past year that an excess of either will make me act really loopy! 😛
When you’re hit by sensory overload, it feels as though your head is caught in a vice grip. Your mind is screaming, unable to focus on anything else but the source of discomfort.
The worst part of it I find is coming across as a complete basket case when overloaded. You don’t get the most sympathetic of looks when you complain about a persistent noise- few can understand how it’s making your brain hurt.
So what does science have to say about sensory processing?
Sensory integration involves three basic sensory systems:
The tactile system (touch)- comprises a series of nerves passing information from the skin to the brain
The vestibular system (sound)- comprises a series of structures in the inner ear involved in movement detection
The proprioceptive system-a series of receptors in the muscle (proprioreceptors) which feed information to the brain about the body’s position
These three systems share a close but complicated relationship which allow us to experience, process and respond to different stimuli. Dysfunction in this network can cause hyper/hypo sensitivity, in addition to problems with coordination, behavior and academic issues.
Evidence from brain imaging studies has also shown that autists experience stronger responses in the brain to sensory stimuli in areas that process sensory information and the amygdala- an area that is involved in attention, emotional reactions and threat response.
But why is this?
Several studies have found evidence of hyper-excitability and hyper-connectivity in the autistic brain.
Evidence shows that in many cases of autism, the neurons located in the sensory cortex of the brain are more sensitive and excitable than others. This is kind of like how a person can be more ticklish in some parts of the body than another- the nerves in the underarm are more excitable than those of the arm.
The autistic brain has also shown signs of hyper-connectivity, where regions of the brain are excessively connected- like an overloaded plug!
This amplifies memory formation, sensory processing and causes an autist to be hyper-emotional, which can make the world painfully intense. Scientists have theorized that autists prefer safe, controlled and predictable environments as a coping mechanism to actively avoid this pain.
Finally, studies have indicated that sensory issues, in addition to a number of other autistic behaviors, may be linked to neurotransmitter (chemical messengers between body and brain) levels in the body. As previously discussed, some neurotransmitters are dysregulated in autism. Evidence suggests that in cases of autism, there are higher levels of excitatory neurotransmitters, and lower levels of inhibitory (i.e. calming) neurotransmitters. These high levels of excitatory neurotransmitters cause neurons to fire excessively, which can influence sensory perception and processing.
I’ll expand a little bit more on the individual sensory issues at a later stage 🙂
A Is For Aoife Not Autism 