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ASD-S2: Demonstrates the ability to adapt, modify, or structure the environment based on an understanding of which auditory, visual or other sensory stimuli may be distracting, offensive, reinforcing, or calming for the individual student under the direction of licensed staff.

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Sensory Strategies That Help

A picture of a boy running with a big orange, rubber ball. When working with an individual with ASD, sensory strategies may be helpful. There are many things that could be included as part of the individual’s sensory program or “sensory diet ,” and they must be selected, designed, and supervised by appropriately trained and licensed professional staff. Some of the strategies that may help include:

Movement activities, such as swinging, rocking in a rocking chair, bouncing or playing on a large ball, or riding on a scooter. Depending on the direction, speed, and rhythm of movement, these activities can be calming or alerting.
Oral motor strategies, such as using a straw or sports bottle to suck; blowing up inflatable toys; doing mouth exercises; using gum or other foods that provide a specific taste, texture, or resistance; chewing or mouthing nonedible objects such as teething rings.
Heavy work activities provide proprioceptive input to the body. Activities in this category include exercises that provide resistance or heavy work to the limbs, such as: pulling, marching, squeezing a “stress” ball, jumping, carrying, and pushing or pulling heavy objects. Use of a weighted vest belt, or ankle wraps provide continuous proprioceptive input. Some good ways to incorporate proprioceptive activities into the day is to assign the individual “jobs” that require heavy work such as taking down or putting up chairs; wiping off the chalkboard or cleaning tables with a wet rag; delivering a bag, box, or stack of books or materials to another teacher; or helping with set up or storage of equipment in the gym (e.g., mats, mini-trampoline, etc.) or classroom.
Deep pressure provides heavy tactile input and includes: massage, hugs, “mummy” wrapping, “squishing” under a pillow, and lying in a beanbag chair or pile of pillows. A common strategy developed by Julia and Patricia Wilbarger (Wilbarger & Wilbarger, 1991), the deep pressure proprioceptive technique (more commonly referred to as the brushing program) combines deep pressure (through brushing the skin) with proprioception through joint compressions. This strategy should only be used under the supervision and direction of a trained therapist.

How Do Sensory Strategies Work?

Sensory strategies work on the nervous system like a protective screen or medication to lessen the effect of more noxious or painfully experienced sensory input. They can be applied in two ways, as a preventative strategy or in response to an immediate need. Just as someone can take an antacid prior to eating a food that causes indigestion, a teacher or paraprofessional can anticipate problems with an individual who demonstrates sensory processing problems, defensiveness, difficulties attaining and maintaining an optimal level of arousal, or experiences unpredictable “meltdowns.” Using a specific program of sensory activities preventatively, a trained adult may be able to assist this student to effectively modify and improve behavior, to maintain an optimal state of arousal longer and recover quicker, to experience fewer and less severe meltdowns, to be more focused and able to attend to specific sensory stimuli..

In addition, when a situation is causing an individual to become upset because of sensory demands that he can’t tolerate a sensory strategy might help the student calm down, tolerate, or participate in the activity. For example, a paraprofessional might be instructed to give an individual a chewy toy or some gummy bears to help him sit and listen during a story time.

In addition to using strategies to effectively provide sensory input in a palatable way to the individual with ASD, it also is important to be aware of ways to adapt the environment or curriculum to decrease aversive sensory input and create a calmer environment. Just like when one has a headache, it helps to create a calmer environment by dimming the lights, slowing down the pace, and decreasing noise. The use of adaptations or environmental modifications can help the individual with sensory issues to better cope in his or her environment.

The following are some ways to adapt the environment based on specific sensory issues. This is just a guide and should be considered generalized examples of strategies, but not a treatment plan for any one individual. The paraprofessional must work with the teacher or licensed staff to assist with this area.

If...	Then modify/adapt by...
Finger painting or play in other messy media is too distressing,	Skipping the activity. Provide an alternative activity like coloring. Allow the individual to watch but not do it. Provide a tool such as a paintbrush, ball, or sponge for the individual to use instead of fingers.
Visual input and activity level in the class is over stimulating,	Positioning the individual facing toward the least amount of visual stimulation, such as a blank wall at the edge of the group if possible. Dim the lights or use alternative lighting (not fluorescent). Have a small, dark space available for a break or as a work space (in or out of the room), such as a large box, under a table, a separate room, or a study carrel.
Standing in line is difficult as evidenced by an increase in activity level or negative behaviors (striking out, yelling),	Positioning the student in front or back of line. Give a “special job” to send the individual ahead of the class, such as delivering a message to the next teacher or have the student follow behind, such as turning out the lights.
Sunlight is too bright and bothersome, and the individual avoids going outside or hides when on the playground,	Having the student wear a baseball cap or sunglasses. Set up activities in the shade. Allow the individual to stay inside or shorten time required to be outside during recess or gym.
A high school student gets agitated during transitions between classes in the noisy, busy hallways,	Giving the student early release from classes to get between classes before everyone else. Schedule classes in rooms near one another to limit the distance required to travel. Assign a locker at the end of the row.
The individual is olfactory defensive,	Avoiding heating food in the microwave if it is in the same room as the individual. Avoid perfume or scented lotions. Minimize use of chemicals or materials with strong smells in the room.
The individual has a daily tantrum before going to or during lunch (it’s over stimulating),	Sending the student to lunch before others arrive. Sit him or her near the exit. Provide an alternative (quiet) place to have lunch.

Which Strategies Should Be Used?

Usually, a trained team, including an occupational therapist, case worker, teacher(s), and other licensed staff, use cues from the individual with ASD to determine what type of input he or she is seeking. Then they choose and design strategies that will provide that input in a structured or organized way. The licensed staff guides the paraprofessionals in how to practically use these intervention approaches.

In general, the goal is to reduce input that is overstimulating to the nervous system and increase input that is calming. The safest and most effective strategies tend to be oral motor, deep-pressure, and proprioceptive input. These tend to calm and regulate the sensory system, are less likely to cause overstimulation, and tend to be sought out by individuals with ASD and sensory defensiveness. Although movement can be a very effective and powerful, helping to calm and organizing sensory input, it should be used with caution. It can be so powerful that if a student gets too much intensity of input, it can cause him to become more disorganized or, for example, cause a person who is prone to seizures to have one. It is critical to have an occupational therapist involved in directing and monitoring use of sensory strategies.

How Can One Tell If a Strategy Is Working?

It is important in using sensory strategies that the entire staff, including the paraprofessionals, knows what behaviors to look for and understand why sensory strategies are being used. Usually, the goal is for the individual to be more organized, attentive, and able to participate in daily activities. With some strategies, one may observe an immediate effect—the individual stops chewing on inappropriate objects when given gum or other chewable items. When strategies are used in a preventative way, the effectiveness can only be seen over the long term.

Sometimes it is easier to determine if the strategies are not working. For example, an individual might pull away, express a look of distress, verbally resist, or act more excitable and less attentive during class. However, just because one staff person gets a negative response once, it does not mean the strategy does not work. It may just need to be done differently, in a different setting, or with a different person

Sometimes strategies will work for a while and then lose their effectiveness and need to be changed. It is important that staff members share observations and work together to make sure that the desired outcome is being achieved, and if not, that changes are made accordingly.

Information in this lesson is used with permission from:

Sievers, P., & Meidle, D. (2002). Sensory issues in ASD. In Supporting students with Autism Spectrum Disorders: The role of the paraprofessional (pp. 55-68). Minneapolis: University of Minnesota, College of Education and Human Development, Institute on Community Integration (UCEDD) and Minnesota Department of Children, Families, and Learning.