Welcome to the August edition of Ask Dr. Emily! We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights here, on the last Friday of each month, in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to theautismblog@seattlechildrens.org

Q: I have a 6 year old son with autism. It is becoming really difficult to take him out in public due to noises and crowds. He has started covering his ears. We will be out somewhere and he’ll become very upset, completely stop wherever we’re at and yell at me to cover his ears along with his hands. He pushes my hands really tight along with his. We started using sound cancelling headphones and it helps, but he still doesn’t want to go anywhere. Is this a stage that will pass?

A: It is not uncommon for individuals diagnosed with autism spectrum disorder to experience sensory sensitivities, such as sensitivity to loud noises, chaotic/busy environments, clothes on skin, or bright lights. I have heard sensory sensitivities being described as “senses on steroids,” kind of like you experience everything others do, but with the “volume” turned way up.

Sensory sensitivities can make what might seem like an easy errand to the grocery, seem overwhelming, unpredictable, and entirely un-fun. It is no surprise that those who experience sensory sensitivities might want to avoid public settings.

It is also not uncommon for individuals diagnosed with autism spectrum disorder to seek sensory input, like asking for pressure (e.g., preferring bear hugs or being wrapped in a blanket or tight shirt) or bringing lights up to the eyes. Sometimes sensory seeking happens in addition to sensory sensitivity, and sometimes it presents alone. I have heard sensory seeking compared to scratching an itch—it feels good (and calming) to have that itch scratched.

Sensory seeking/sensitivities are often something that stick with a person throughout their lifetime, though to varying degrees and with varying likes/dislikes. While sensory seeking/sensitivities may not go away completely, individuals often learn to cope with them, so that the impact on daily functioning is less pronounced. For example, one might chew gum rather than chew clothing or use a weighted blanket to calm the body at night.

Q: My son is 8 years old and has autism My question is do children with autism eat with their hands? My son does not use utensils. I believe he could and he has the motor skills I believe, but he chooses to scoop food up with hands and eat it. It’s ok and no harm is done, but I am curious if this is an “autism thing”?

A: We can really only speculate here. While eating with hands is not officially an “autism thing,” I often hear families talking about hand eating as something they experience. I have a lot of ideas about why hand eating happens, none of which might actually be the reason. For example, children with autism often experience delays in the development of fine motor skills (meaning, things we do with hands/fingers, like writing, buttoning buttons, and yes, eating with utensils), making eating with utensils challenging. It may just be easier and faster to eat with hands than it is to fuss with utensils. Sensory sensitivities or seeking could also be contributing; the metallic taste of a fork or cold feeling of the metal might be off-putting. Or it could be that the feel of food on the fingers is pleasurable. Our kids also don’t always feel social pressure to do what others are doing at the table, so use of utensils just might not seem necessary.

Dr. Emily Rastall is a clinical psychologist at Seattle Children’s Autism Center, where she works to evaluate and treat children and families affected by autism spectrum disorder and related or co-morbid disorders. The information contained in this blog should not be used to replace the relationship that exists between you and your healthcare provider. Please contact your healthcare provider for specific medical advice and/or treatment recommendations.