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Autism and Anxiety Caused by Sensory Overstimulation

According to the CDC, one of the diagnostic criteria for autism is “hyper- or hypo-reactivity to sensory input,” and a recent scientific study published in 2020 found that about 90% of autistic people experience this symptom. Sensory experiences to which one might be sensitive can include (but are not limited to) sounds, smells, textures, physical contact, or visual stimuli like bright or flickering lights. Even those that are barely noticeable to one person might be unpleasant or even painful to another.

While autism is a spectrum and no one autistic person will experience the exact same symptoms as another, overstimulation may be more commonly experienced by autistic people due to differences in certain systems of the body and/or neurological variables. In combination, these physical variances can lead to increased sensitivity to different kinds of sensory stimuli, as well as difficulty with self-regulation.

Prolonged exposure to overwhelming sensory experiences can lead to anxiety, especially if it’s difficult to avoid or escape from them. In fact, anxiety can develop even if a person isn’t currently experiencing sensory overload – they might know that they’re likely to experience it in the future and be concerned about how it’s going to affect them or worried about how (or if) they’ll be able to take care of themself!

In this blog post, I’ll review some identifiable signs of sensory overstimulation and anxiety, and suggestions for how to take care of yourself or an autistic loved one when those symptoms occur.

A child's hands while engaging in a colorful sensory activity

Identifying Sensory Overstimulation

The clearest signs of sensory overstimulation are probably a person’s attempts to get away from the unpleasant sensory experiences. If a person isn’t able to verbally express that they’re uncomfortable, or can’t leave the environment freely, you might be able to tell that something’s wrong based on actions like them squinting their eyes shut, covering their ears, pinching their nose, or taking off itchy items of clothing. Behaviors like these should never be punished as they’re usually simply signs of discomfort – the cause should be addressed, not the symptom!

Sometimes, though, escape and relief aren’t possible by those more straightforward means. For example, someone may not be able to precisely identify exactly what is wrong or may be unable to clearly communicate the problem to others such that it can be addressed. Perhaps they’ve become so overwhelmed that, while in other circumstances they would be able to find a solution or ask for help, in this case a “meltdown” is the only remaining option.

Initially, behaviors like crying or self-soothing may occur. The latter might include rocking back and forth, pacing, or fidgeting. In some cases, continually escalating aversive sensory experiences can evoke dangerous or self-harming behavior. From a behavior-analytic perspective, this makes perfect sense. Other methods of relieving the overstimulation haven’t been or aren’t currently effective, but other people in the environment are very likely to react and problem-solve if they observe aggression or self-injury. Often, behaviors that appear extreme to outside observers are the last-ditch option to take care of and protect oneself. These are cases when ABA services can be especially helpful in identifying what exactly in the environment is causing these behaviors, how aversive stimuli can be reduced or eliminated if possible, and how families can support each other in identifying that anxiety or discomfort are building up antes de behavior escalates to a dangerous level.

Identifying Anxiety

Anxiety is a complicated disorder involving many interacting systems within the body, but in a nutshell, it occurs when the body perceives itself to be threatened. The threat may not be “real” in the sense that something bad is truly currently happening or about to happen, but it certainly feels real enough to the person experiencing it!

When the body reacts to a perceived threat, symptoms of anxiety are then caused by “stress hormones” like adrenaline and cortisol. Recent studies have suggested that anxiety is experienced more often by both autistic children y adults in comparison with neurotypical peers, possibly in relation to sensory reactivity differences.

Of course, anxiety can be caused by many factors aside from sensory reactivity and overstimulation, and it’s helpful to be able to identify its signs independent of reactions to specific sensory experiences. If anxiety seems to be more continually present rather than acutely caused by observable circumstances, it may be a good idea to seek out more intensive mental health support.

You might be able to tell you or a loved one are experiencing anxiety based on:

  • Increased heart rate
  • Rapid or shallow breathing
  • Sweating
  • Gastrointestinal distress
  • Dizziness or confusion
  • “Shutting down” and not appearing to react to things in the environment, which may indicate dissociation

How to Help

Anxiety is often treated with a combination of medication and talk therapy, but anxiety caused by sensory overstimulation can be prevented by environmental adjustments, and behavior-analytic services can help in pursuit of that goal. In cases when overstimulation can’t be reliably prevented, ABA can still be helpful in teaching communication and coping skills.

We’ve already covered some suggestions for how the environment can be adapted to relieve sensory overstimulation in a previous blog post, How to Support Autistic Loved Ones at Home – here’s a recap along with a few more!

  • Eliminate or decrease the presence of aversive stimuli in the environment. If possible, simply prevent the sights, smells, or sounds from becoming overwhelming in the first place! This can be easier said than done if you’re not sure exactly what triggers overstimulation, but careful observation can help solve the puzzle.
  • Provide support aids to help overcome the overwhelming stimuli. Of course, not all sensory experiences can be prevented, especially outside of the comfort of one’s own home. In these cases, different kinds of items that mask the uncomfortable stimuli can help. For example, I almost always wear my beloved Loop earplugs when I’m working in order to muffle distracting sounds! Someone could also wear sunglasses or a hood to block visual stimuli or carry a potpourri sachet to sniff and concentrate on when in an environment with many overwhelming scents.
  • Provide calm spaces to retreat to. If aversive stimuli can’t be eliminated or masked, it can be very helpful to have a contingency plan in place allowing for escape to a calmer environment. This might entail simply retreating to a bedroom for a break during a party or leaving a restaurant or store to sit in the car or a bathroom stall for a few minutes. This is sometimes perceived to be rude or inconvenient, but it is FAR preferable to experiencing an overstimulated meltdown, and society as a whole could do a lot better when it comes to understanding and supporting accommodations such as these.
  • Prompt coping skills. As I noted earlier in this post, one factor that may connect autism to anxiety caused by overstimulation is difficulty with self-regulation. Some common coping skills used to support that process include deep breathing exercises, mindfulness, meditation, and physical movements like stretching. It can be difficult to engage in new skills like these while in the middle of an uncomfortable experience, so it’s important to practice and become fluent with them when symptoms of anxiety or overstimulation aren’t actively present!
  • Provide distractions. Sometimes, having something else to think about and engage with can be enough to relieve symptoms of overstimulation and anxiety. Examples might include talking about a favorite topic, singing a song together, or taking a walk. However, keep in mind that in other cases distractions can be very counterproductive if the extra interaction just adds to the experience of overstimulation. Continually check in with your loved one (or yourself!) to be sure that this solution is actually effective.

As I’ve highlighted throughout this post, ABA services can provide support in identifying the precise causes of overstimulation and anxiety, making changes to the environment to reduce discomfort, and teaching skills for coping with aversive experiences when they do occur. We’ve also provided recommendations for other forms of therapeutic services in a past blog post linked here!

If our Waypoints team can be of any help in finding or providing support services for you or a loved one, I hope you’ll contact us at info@waypoints.life.

Change the environment in simple ways – sounds, scents, and textures that don’t even register to you may be very aversive to others! Sensory sensitivities can often be fairly easy to address. It may be helpful to provide clothes and bedsheets made from particular fabrics, cook stronger-smelling foods when you’re loved one is out of the house, or have noise-cancelling headphones available during loud home improvement projects. Everyone’s sensitivities are different, so ask what adjustments might be most beneficial, or keep an eye out for what sensations appear to be distressing.

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