I promised I would return to this topic to discuss vestibular and proprioceptive processing. I may be wrong, but my instinct is that you probably don’t know much about those terms. I certainly didn’t until quite recently. Let me first explain the two things:
Vestibular: this term comes from the word ‘vestibule’ which refers to a cavity or hollow space serving as an entrance to another cavity or space, in this case within in the internal ear. The vestibular system, then, informs movement and balance.
Proprioception: this is defined as an unconscious awareness of movement and space due to one’s own body. The proprioceptive system is what enables an individual to be aware of their own body and its place and position in the world and in relation to other people and objects.
As with the other sensory systems, people with Autism usually experience hyper or hypo sensitivity in these areas.
Have you ever seen people with Autism spinning around? Or bouncing from one foot to the other? Or jumping up and down? It is likely that this is due to hypo-sensitivity in the vestibular system. When people seem to feel less movement in every day living, they compensate by creating their own movement. I have seen people spin round and round and round on their feet while looking up at the ceiling and never seem to get dizzy or fall over. I tried it once, to see what it felt like, and I immediately tumbled on my face. This is because my vestibular system works in a different way from theirs. I get enough stimulation through my every day walking, sitting, standing up, playing sports etc and anything extra will probably tip the balance the over. But some people don’t get the response that they need from these activities and so they seek out things that will work for them. Many people with Autism love roller coasters or play ground rides for this reason.
Of course where there is hypo-sensitivity, there is also hyper-sensitivity and so for other individuals they will experience the opposite to what I have described. These individuals will get so much feedback from just standing or walking that to us it would be as if we were on a constant roller coaster. The result being that they would be frightened to do many things that involved excess movement such as riding in a car or going up and down stairs.
As with the other sensory systems, strategies can be put in place to address the balance of a person’s vestibular system. These will have to be bespoke and specifically designed to meet the individual’s exact situation. For someone experiencing low vestibulary sensation, it may be beneficial for them to go on fairground rides, roundabouts or specially designed equipment such as an ‘i-joy’ or other movement and spinning machines. In the opposite direction it is possible to put strategies in place to help desensitise the vestibulary system such as using weighted blankets, gentle movement activities or water beds.
The proprioceptive system, as I said, relates to an awareness of one’s own body in space and relation to others and objects. Some people with Autism will seem clumsy, or may seem to enjoy big bear hugs and massages, grind their teeth or bite and chew on things. One reason for these things (and there could be others) is a hypo-sensitivity in the proprioceptive system. Again, this means that they experience less sensation from activities and movements than others would and so they seek out things to give them the response they need. In managing this type of sensitivity, things like employing deep pressure and massage are often effective as they can give the muscles the desired feeling. Problems occur when people with Autism go looking for the responses they need in ways that can be damaging or dangerous, for example hitting themselves or using objects to hit themselves with.
The proprioceptive system receives a lot of feedback through the jaw. This is why people with Autism will often bite or chew on objects; their body is receiving the stimulation that other people’s gets just through every day living. It can be frustrating when clothing or objects are being chewed through, particularly if the individual is an adult and therefore has a fairly strong jaw! There are some great chews that can be bought from a whole variety of places, including Amazon, that look fairly unobtrusive and can be worn on a necklace so the individual can just pick it up and chew it when they need to.
The other thing to remember is that a person’s sensory processing system across all areas will change from time to time, as does anyone’s. Sometimes I will find that bright lights really bother me so I have to wear sunglasses every time I drive in the summer, even when the sun isn’t particularly bright. When we are feeling a little run down or tired, we will often become more sensitive to sounds. These things happen with people with Autism and other sensory processing difficulties too, only they may be more pronounced and more frequent. Working with individuals experiencing these kinds of difficulties is a constant evaluation process to ensure that their environment is structured to the best it possibly can be to help them cope with the world as best as possible.
I want to finish by just re-iterating that I am not a diagnostician. I am not an occupational therapist and the words I write here are purely from my own observations and experiences. I have read many books and worked closely with OTs and speech and language therapists, but as I said, I am not qualified in these areas. I am, however, very interested in people and in finding ways of making people’s lives as easy and happy as possible. For people with Autism this can be complex and frustrating for both sides, but it is so worth it when we manage to get something right, or ‘fix’ something that was out of balance.