Sensory processing disorders and autism
Many children with an autism spectrum disorder (ASD) struggle with sensory issues including sensory processing disorder (SPD). Chantal Sicile-Kira, “The Autism Advocate,” describes SPD as “a neurological disorder that causes difficulties with processing information from the five senses: vision, auditory, touch, olfaction, and taste, as well as from the sense of movement (vestibular system), and/or the positional sense (proprioception). For those with SPD, sensory information is sensed, but perceived abnormally. Unlike blindness or deafness, sensory information is received by people with SPD; the difference is that information is processed by the brain in an unusual way that causes distress, discomfort, and confusion.” (Sicile-Kira, 2010)
While the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not list sensory processing disorder or issues in their diagnostic criteria for autism, psychologists note that it is rare that a child with autism does not experience sensory processing issues to some extent. According to a study published in Pediatric Research, “over 96% of children with ASD report hyper and hypo-sensitivities in multiple domains…and these behavioral differences can endure through adulthood.” (Marco, Hinkley, Hill, & Nagarajan, 2011) Like autism, sensory processing disorder is experienced on a spectrum and will affect each person uniquely.
How anxiety and sleep dysregulation affects children with autism
According to Indiana University Resource Center for Autism (IRCA), 40% of children with autism have one or more comorbid diagnosed anxiety disorder. (Merrill) IRCA reports that the prevalence of specific anxiety disorders is:
Specific Phobia: 30%
- “People with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there’s no threat or danger. The fear may not make any sense, but they feel powerless to stop it.” (ADAA)
Obsessive-Compulsive Disorder: 17%
- “A common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over” (National Institute for Mental Health, 2016)
Social Anxiety Disorder/Agoraphobia: 17%
- “Social phobia (also called social anxiety) is a type of anxiety problem. Extreme feelings of shyness and self-consciousness build into a powerful fear. As a result, a person feels uncomfortable participating in everyday social situations.” (Lyness, 2013)
- “Agoraphobia is an intense fear and anxiety of being in places where it is hard to escape, or where help might not be available. Agoraphobia usually involves fear of crowds, bridges, or of being outside alone.” (U.S. National Library of Medicine, 2017)
Generalized Anxiety Disorder: 15%
- “Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things.” (ADAA)
Separation Anxiety Disorder: 9 %
- “The essential feature of separation anxiety disorder is excessive anxiety concerning separation by a child from the home or from those (in adolescents and adults) to whom the person is attached. This anxiety is beyond that which is expected for the individual’s developmental level. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.” (Bressert, 2017)
Panic Disorder: 2%
- “Panic disorder is diagnosed in people who experience spontaneous seemingly out-of-the-blue panic attacks and are preoccupied with the fear of a recurring attack.” (ADAA)
Anxiety disorders can lead to the further issues of sleep deprivation and dysregulation and create a cycle of imbalance in children and adults. According to the National Sleep Foundation, “At some point, it’s hard to tell whether you’re having trouble sleeping because you’re anxious, or you’re anxious because you can’t sleep. The answer may be both. It’s a two-way street: Stress and anxiety can cause sleeping problems, or worsen existing ones. But lack of sleep can also cause an anxiety disorder.”
Kim West, LCSW-C, identifies the following 11 consequences of sleep deprivation specific to children:
- Overly emotional (explosive temper tantrums, easily hurt feelings, no patience)
- Difficult to wake in the morning
- Difficulty concentrating or focusing during play
- Taking long, or excessive naps
- Defiant or contrary behavior
- Difficulty falling asleep (overtired)
- Falling asleep as soon as they hit the pillow (sleep should take about 20 minutes for a healthy sleeper)
- Increased appetite
- Accident prone, or clumsy
- Excessive talking (more questions than normal or frenzied conversation) (West, 2016)
When children with autism are stuck in the cycle of anxiety causing sleep dysregulation and, in turn, sleep deprivation causing anxiety, parents are often left wondering what they can do to break this cycle. Holistic options are often more favorable over medication for many families as a first option. Weighted blankets have become an increasingly popular option for both children and adults on the autism spectrum and those who are neurotypical to aid in anxiety reduction and help achieve a better night’s sleep.
Weighted blankets as a tool for better sleep and anxiety reduction
Weighted blankets come in various sizes and weights and provide deep-touch therapy or deep-pressure stimulation. Clinical studies suggest this sensation, similar to being held or hugged, releases serotonin which helps to regulate sleep and mood. Springbrook Behavioral Health likens this deep-touch therapy to other vestibular activities such as yoga, heavy work such as hopscotch or raking leaves, and swimming.
Applied Behavioral Analysis EDU describes the biological processes that take place when a weighted blanket is used:
“When you apply deep pressure to the body, the body switches from running its sympathetic nervous system to its parasympathetic nervous system. This is the so-called switch from “fight or flight” to “rest and digest”…Unfortunately, kids with autism spectrum and sensory processing disorders spend a lot of time stuck in the sympathetic nervous system. Even when they do calm down, it takes very little to retrigger this system…As deep pressure is applied to the body, the parasympathetic nervous system comes online, calming your child and bringing a sense of well-being.” (ABA EDU)
Weighted blankets can be particularly effective for children during times of heightened anxiety, while trying to sleep, or when sensory processing issues become overwhelming. Some children also enjoy using their blanket as a source of comfort while watching TV or lounging. They are especially effective when creating a sensory space for your child with autism.
Applied Behavioral Analysis EDU describes these positive effects of deep-pressure stimulation:
- General sense of calm that can last up to a few hours after therapy
- Decreased overall anxiety when practiced regularly
- Increased happiness
- Improved social interactions
- Increased communicativeness
- Better sleep
- Improved focus
- Lowered incidence of seizures
- Lowered hypersensitivity to touch
- Improved ability to tolerate the school environment
- Decrease in self-injury
Best weighted blankets for adults and adolescents
Children are not the only people who benefit from the calming effects of weighted blankets and deep-pressure stimulation. Biologically, the adult and adolescent body will have the same release of endorphins children feel. As autism, anxiety, and sensory processing disorders need to be managed throughout an individual’s lifetime, many adults and adolescents find comfort in having a variety of tools available to them. Most of the same retailers who sell weighted blankets for children have an adult line with different fabrics, weights, and patterns. All of the retailers linked below also sell blankets appropriate for adults and adolescents.
Selecting a weighted blanket for your child
In selecting the best weighted blanket for your child, parents must take into consideration the child’s weight, height, and even their bed size and color preferences. Mosaic Weighted Blankets, a trusted weighted blanket supplier, suggests the blanket should weigh 10% of the child’s body weight plus one or two pounds. Their website features a chart that can help you determine the best weight blanket for your child. Is especially important for young children not to have a blanket that is too heavy. If you are still unsure of the best blanket weight for your child, a therapist or doctor should be able to advise you on what will work best for your child. An increasing number of therapists keep weighted blankets in their offices that a child can try before your purchase.
Weighted blankets come in a variety of materials including cotton, antimicrobial fabrics, minky, chenille, fleece, cooling fabrics, or waterproof fabrics. Depending on your child’s sensory preferences, blankets can often be made out of custom fabrics as with The Magic Blanket. The filling of weighted blankets is as diverse as the fabrics with which they can be made. The most common fillings are polypropylene pellets or glass beads.
Where to buy a weighted blanket
As weighted blankets increase in popularity, more retailers are cropping up. While it is important to be sure your child’s weighted blanket is well constructed and uses appropriate fillers, consumers have an increasing number of retailers to choose from when purchasing.
As mentioned above, Mosaic Weighted Blankets is a popular option. They have a large variety of blankets and wraps to choose from allowing consumers to customize their blanket’s material, size, and weight more than many other retailers. They also offer a DIY kit for families feeling adventurous. Their children’s blankets tend to hover around the $100 price point.
The Magic Blanket, another popular retailer, has a large variety of fabric options and allows the customer to email them with custom orders. Their website houses an extensive review section and answers frequently asked questions. They offer military and law enforcement discounts and their blankets tend to range from $70 to $120 depending on the fabric.
Weighted Comforts, run by a mother and son team, make weighted blankets in partnership with Sew for Hope. Their blankets come in neutral tones and quilted or Coolmax fabrics. Their blankets are most appropriate for older children, adolescents, and adults as their blankets tend to be heavier. Their prices range from $195 to $299 depending on the fabric.
CapeAble Sensory Products is an award-winning company started by two mothers, Marna Pacheco and Susan Hickok, who were inspired to create their own products to provide comfort and focus for their daughters with special needs. Today, CapeAble Sensory Products offers weighted blankets, weighted wearables, and sensory enrichment tools at a variety of price points that deliver deep pressure touch stimulation, enabling the central nervous system to communicate most effectively with the brain.
If you prefer to purchase through Amazon, be sure the retailer you chose uses a certified and safe filling as well as taking care to select the appropriate weight for your child. Popular and well-reviewed brands available on Amazon include Platinum Health and YnM.
As always, if you have questions about the most appropriate blanket for your child, seek the advice of an occupational therapist, pediatrician, or psychologist.
Sicile-Kira, C. (2010, March 02). What is Sensory Processing Disorder and How Is It Related to Autism? Retrieved 2018, from https://www.psychologytoday.com/blog/the-autism-advocate/201003/what-is-sensory-processing-disorder-and-how-is-it-related-autism
Marco, E. J., Hinkley, L. B. N., Hill, S. S., & Nagarajan, S. S. (2011). Sensory Processing in Autism: A Review of Neurophysiologic Findings. Pediatric Research, 69(5 Pt 2), 48R–54R. http://doi.org/10.1203/PDR.0b013e3182130c54
Merrill, A. (n.d.). Indiana University Bloomington. Retrieved 2018, from https://www.iidc.indiana.edu/pages/anxiety-and-autism-spectrum-disorders
How Does Anxiety Affect Sleep? (n.d.). Retrieved January, 2018, from https://sleepfoundation.org/sleep-disorders-problems-list/how-does-anxiety-affect-sleep
West, K. (2016, November 11). 11 Negative Effects of Childhood Sleep Deprivation. Retrieved January, 2018, from https://sleeplady.com/toddler-sleep-problems/11-negative-effects-of-childhood-sleep-deprivation/
Sensory Processing activities for children with Autism. (2017, February 07). Retrieved January, 2018, from https://springbrookautismbehavioral.com/portfolio-item/using-deep-pressure-stimulation-to-improve-sensory-processing/
- (2016, January). Obsessive-Compulsive Disorder. Retrieved January, 2018, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml
Lyness, D. (Ed.). (2013, May). Social Phobia. Retrieved January, 2018, from https://kidshealth.org/en/teens/social-phobia.html
- (2017, December 21). Agoraphobia. Retrieved January 26, 2018, from https://medlineplus.gov/ency/article/000923.htm
- (n.d.). Specific Phobias. Retrieved January, 2018, from https://adaa.org/understanding-anxiety/specific-phobias#
Bressert, S., Ph.D. (2017, August 24). Separation Anxiety Disorder Symptoms. Retrieved January, 2018, from https://psychcentral.com/disorders/separation-anxiety-disorder-symptoms/
- (n.d.). What is Deep Pressure Stimulation? Retrieved January 26, 2018, from https://www.appliedbehavioranalysisedu.org/what-is-deep-pressure-stimulation/
Katherine G. Hobbs is a freelance journalist and university student studying English, with an emphasis on journalism, and psychology. She is interested in the impact of having a special needs child on the family dynamic. Katherine is dedicated to bringing awareness of resources to families and providing help to those who love their autistic children. You can find her online at katherineghobbs.com.