Help for My Son’s Sensory Issues

Is your child sensitive to loud noises? Bright lights? Physical contact? Learn about effective strategies for investigating, addressing — and even resolving — hypersensitivities in teens with ADHD.

Q: “My 15-year-old son is diagnosed with ADHD, and he also has sensory challenges. He is very sensitive to loud sounds, and he shies away from bright lights and physical contact, like a hug or a pat on the back. How can I change his environment to help him manage these issues?”

Many children with ADHD have sensory processing challenges. The starting point is to assess any underlying medical issues that may be contributing to sensory differences, which can adversely affect attention. Approach your son’s sensory challenges with these three steps:

1. Assess Your Child’s Senses

Let’s start with your son’s auditory behaviors. Children who have had frequent ear infections may have residual fluid in the ear that distorts sound. A child may have a condition called hyperacusis, hearing noises at a significantly lower volume than typically heard. Such a child hears more than we do, with his auditory system flooded with noise that demands he figure out how to filter out irrelevant sounds and tune in to what’s important. For some kids, particular sound frequencies are uncomfortable. Start by getting your child’s hearing assessed, with an audiogram that begins at -15dB, a lower level than is typically tested for.

2. Protect Your Child’s Senses

Our first job as parents, therapists, or teachers is to protect children from pain. This includes providing protection from truly intolerable noise. You can offer your child sound-reducing headphones for short periods (when attending a noisy gathering or during a thunderstorm). For an older child, high-fidelity earplugs provide the full spectrum of sound and reduce the overall volume. Save these protective devices for brief periods so that your child’s auditory system doesn’t recalibrate!

3. Strengthen Your Child’s Skills

The goal is to have your child tolerate all kinds of noise. You can record a noxious sound and listen to it together at home, where there is less stress. For example, if the sound of construction vehicles sends your child into a tailspin, do not avoid construction sites altogether. Record the sounds, take photos of the vehicle, and explore the sounds and the sight at home while eating something he likes. Consult an occupational therapist about a therapeutic listening program that can boost his auditory sensory skills—in effect, you’re exercising his hearing system as you would exercise weak muscles. Speak with an audiologist or speech therapist about an FM System. Your son can use this device at school. The teacher speaks into a microphone and her voice goes directly into your child’s ear channeled through a headset, earbuds, audio speaker, or cochlear implant.

[Could Your Child Have Auditory Processing Disorder? Take This Test]

You can use this three-step approach to manage your son’s other sensory challenges, including his visual hypersensitivity. First, get a comprehensive exam from a developmental optometrist who specializes in children’s functional vision (find one at covd.org). Get any appropriate corrective lenses, and consider color filter lenses (irlen.com), and a wide-brim hat to protect eyes from sun and downcast lights. Replace fluorescents and “daylight LEDs” with full-spectrum bulbs or warm LEDs. Add dimmer switches if possible. You can work with an occupational therapist to increase ocular-motor, cognitive, and sensory-based visual processing skills.

4. Create a Sensory Diet

As to changes to your son’s sensory diet, this is best done in collaboration with an occupational therapist. This professional will assess his current sensory processing skills, provide therapeutic interventions, and teach you how to implement a home program with a sensory diet that meets his needs.

A child who tends to be over-stimulated needs a safe haven where he can take a break when feeling overwhelmed. This may include a heavy lap pad or gravity blanket (no more than 10 percent of your child’s body mass), a vibrating toy, soft lighting, cozy seating, and music he really loves to listen to.

To increase deep pressure tactile input, have him wrap himself in a blanket or thin mat, use a heavy item — a vest, lap pad, or toy — a foam roller to “roll out” muscles like cookie dough, or a snug-fitting compression garment. “Heavy work,” which uses the big muscles and joints of the body, also helps kids stay organized and grounded. Climbing stairs, hanging from monkey bars, jumping on a trampoline or a mattress pad on the floor, even pulling wet clothing out of the washing machine, can also help him feel in control of his sensory experiences and his everyday life.

Sensory Issues In Kids: Next Steps

Lindsey Biel, M.A., OTR/L, is a pediatric occupational therapist with a private practice in New York City. She evaluates and treats children, adolescents, and young adults with sensory processing issues, developmental delays, autism spectrum disorders, and other challenges. She is co-author of Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensor Processing Issues.

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