Some 12-15 years ago, Louisville, Kentucky became the first “Autism-Friendly City” within the United States. Back then, San Diego was known for being «bicycle-friendly», San Francisco was «vegan-friendly», but what about making a city «autism-friendly»?  The designation was kickstarted by a meeting with the Mayor of Louisville, a press conference, and the signing of a document with the seal of the city.  After the press conference, the local support organization (FEAT), brought together all autism service providers of the city of Louisville to the same round table.  Brainstorming provided a list of what parents thought was still needed, what was duplicated, and a set of priorities -what efforts should be tackled first?

One of the main concerns at the meeting was the lack of activities available for autistic children.  A wish list of possible activities included summer camps, swimming classes, and being able to visit the local children’s science museum, the supermarket, or even the movie theater. You could visit all of these places with your autistic child, but occasionally the visit transformed into a traumatizing experience. Indeed, after a few minutes at the children’s science museum, the environment assaulted the sensory systems of the children who then reacted accordingly. What could be done in order to enjoy these activities?  We could not change the sensory sensitivity of our children, but could we accommodate for them?  Fortunately, the managers of the Children’s Science Museum and the local movie theater were markedly receptive to suggestions.  This allowed for special days when our children could attend and enjoy those activities.

The following is a list of suggestions that, during the years, I have seen as being useful when building a sensory friendly environment for autistic children. Remember that one size does not fit all, and individual measures may be needed in some cases.

The first and major intervention is probably the most sensible one.  We need to decrease the overall amount/level of stimulation within the environment; whether it is sound, smells or lights. Headphones and eyeglasses with filter lenses can help attenuate some of the stimulation. It has been my experience that those autistic individuals who are most sensitive to sounds also tend to suffer from tinnitus. I will come back to this point sometime in a future blog.

Environmental stimulation, when present, needs to be predictable.  This means, for example, no jarring sounds at the movies. The loud, long, explosive sounds of horror films and war movies provide for great special effects but may prove injurious to our autistic children. (Note: Movie theater chains, like AMC, provide lists of sensory friendly movies and participating theaters), The use of noise cancelling headphones is especially useful as they tend to cancel both loud noises and the low-level rumble of the background- in this regard they provide for acoustic consistency!

Establish a regular routine when possible.  Familiarity is the key to success! Explain the activities by storytelling and drawing pictures beforehand. Arrange to have the same person as a guide throughout the stay. Allow children to bring transitional objects during such visits.  These are objects from a patients’ familiar environment, which makes them feel at ease.  Consider enlisting occupational therapy and applied behavioral analysis students to join you in the activities.  Such company may not only prove educational for them but it will also be helpful to you.  Some of the greatest friendships I have seen develop with autistic children were born out of the willingness to help from Girl Scouts.

When partaking in one of the aforementioned activities, a special room may be set aside for children who are still overwhelmed by the environment.  In these «calming rooms» special gel filters may be placed over fluorescent lights to smooth out their flickering effects. Bean bags, instead of chairs, help promote relief by pressure. Whole body swings provide for a soothing rocking motion while simultaneously allowing parents to embrace their children. While swinging, rhythmic patterned motions are always preferred.  Animal pet therapy has been a game changer in such calming rooms.  Talk to your local children’s hospital about their resources for pet therapy and try to enroll them in your activities.

It is worthwhile to train those people who provide customer services at your activities.  Invite them beforehand to your support/planning meetings and provide them with educational material.  Talk to them about problems with personal space regulation.   Let them know the importance of not talking down to the children and of allowing them sufficient time to process questions and to make choices. Give children warnings and options whenever touch or proximity is necessary. Make them aware that problems with internal body sensations (interoception) makes it difficult for our children to provide warning signs for possible hunger, the need to go to a bathroom, or to manifest emotions that are appropriate in response to the environment.

Simple changes can make a difference in the lives of our children.  Indeed, some easy to make accommodations will provide a shared benefit to all autistic children within a community. Buckminster Fuller said, “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”

References

Casanova MF. Autism Updated: Symptoms, Treatments and Controversies. Amazon Publishing, 2019.

Casanova MF. Visual sensitivity and autism. Corticalchuavinism.com

Casanova MF. Interoception: The Eight Sensory System. Corticalchauvinism.com