When a spoon falls - sensory overload in profound autism

How the senses show themselves in profound autism, and why the responsibility moves to the person who is watching.

In the afternoon a spoon falls on the floor, and everything falls apart. The people around see the outburst and think: it came out of nowhere, a spoon is a small thing. But nothing happens out of nowhere. It came from a whole day of build-up.

In the morning the light came from a different angle, because it is spring. There was a substitute teacher at school. Music was playing in the canteen. The car had a new air freshener. The spoon was not the reason. It was the last drop into a bucket that had been filling all day.

An ordinary environment can be unreasonable

In profound autism the brain does not filter sensory information the way most brains do. The hum of a fluorescent tube, the stiffness of clothes, the smell of food, the tone of another person's voice, the brightness of a shop: each of these is a drop of water into the bucket. A neurotypical person can buffer. A person with mild autism can buffer to a limited extent. A profoundly autistic person often does not buffer at all, and the body reacts.

Just sitting in an ordinary room can use more brain capacity than a neurotypical person's whole morning. An ordinary environment can be unreasonable for a profoundly autistic person.

The senses are not fixed traits either. The same person may tolerate noise reasonably well in the morning and shut down completely at a small sound in the afternoon. The same person may enjoy a bath one day and refuse to touch water the next. The same sense can be over-responsive at one moment and under-responsive at another, and different senses can pull in different directions at the same time: a person covers their ears in noise while seeking strong pressure on their body. A badly slept night, constipation, pain or a stressful situation can wipe out sensory tolerance entirely. If sleep has been poor, the bucket is already half full in the morning. If the week has been heavy, Thursday's meltdown may come from what happened on Monday.

What it looks like when there are no words

Here is the feature of profound autism that changes everything. The person does not know where the level in the bucket is. They do not recognise their own load until it spills over. And when it spills over, they cannot say in words what was too much.

That is why sensory load shows in behaviour. A person who cannot say "this shirt hurts" may respond with the only means available: hitting, kicking, withdrawing. They may live in a constant sound environment that is actively painful, and nobody necessarily knows. Head banging can be an attempt to cover an external sound with stronger feedback from one's own body. Making a loud noise can be self-soothing, because your own voice is predictable and controllable in a way the sounds around you are not. Selective eating is a survival strategy of the nervous system.

And because the body communicates pain in the same language, toothache, an ear infection and constipation may show only as behaviour. If the physical cause of the behaviour is not seen, a person may be treated psychiatrically in a situation where the right help would be pain relief, treatment for constipation, or a filling.

One example from my guide. A person bangs their head in the afternoons. The people around interpret it: he does this to get attention, it is a habit. The likely correct interpretation: in the afternoons the neighbour starts walking the dog, and the barking carries through the wall. The person cannot say that the sound hurts. Try ear defenders before it starts. If the banging stops with the ear defenders, the sound was probably the reason.

Another example that many parents recognise. Every day after school the child comes in, throws shoes, breaks things, shouts. The wrong interpretation: at school he behaves, at home he does not, he is disobedient. A possible correct one: the nervous system has masked all day, and at home, in a safe environment, it lets go. Try a release point in the hallway, big cushions that can be thrown, and a coming-home ritual: shoes off, ten minutes of release, own time, then everyday life. Do not ask anything straight away.

The responsibility moves to the person who is watching

From this follows the most important idea in this text. When a person cannot tell you, and usually cannot regulate or avoid the load themselves, only the other people in the environment can see the signs. The responsibility lies with the environment. You are their voice.

In practice that means a few things. The first step is always: stop, observe, do not assume. Rule out a physical cause first, before any other interpretation. Look at the build-up rather than only the moment: what has happened during the day and the week before the meltdown. And when a person cannot regulate themselves safely, we have to regulate the environment.

Not everything has to be fixed at once, and one right change can make everyday life easier immediately. Quieten one sound, dim one light, protect one place of their own, and take ear defenders with you to the shop and to parties. Strong even pressure is almost always better than light brushing touch. The purpose of a sensory environment is to find the amount and quality of sensory information that suits this person.

Do not dry the floor, empty the bucket. Most of the drops are sensory.

When the nervous system is at peace, the person can come forward.

This text is based on the guide The sensory world in profound autism, which goes through each sense in turn: the signs of over- and under-responsiveness, the wrong and the right interpretations, and concrete measures for the home, the school and the supported housing unit.

Lainattu Rauha®-Borrowed Peace

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