A series of behaviors in autistic children, not well addressed by medical providers today, include self-harming, hitting, biting, mouthing, licking objects, pickiness with food, clothing textures, and touching private areas – otherwise known as “sensory behaviors.” Some of these behaviors, often found to be embarrassing, can remain prevalent and persist into adulthood. Part of the problem is that medical providers typically are not educated regarding the nuances of these unique autistic behaviors. Providers know in general how to refer to specialists for behavioral treatment in the case of autism. Specific therapies target certain behavioral issues. The behaviors mentioned above are sensory in nature. Families frequently struggle with the existence of these behaviors in their children, silently. What can we, as medical providers, offer these patients and families? This article offers some awareness for medical providers about the existence of these problems.
These sensory behaviors typically start when children are toddlers. These are behaviors that are present even in mildly autistic individuals. Typically, parents may speak up about these behaviors only when the children get in trouble at school or daycare. Families are aware that the problem exists but lack the tools to address the problem at home. A parent may receive a complaint from daycare that their child is biting others at school. At times, these behaviors are discovered because the individual has a run-in with the law and, in the process, is referred for further evaluation to a psychologist or psychiatrist. In some instances, these individuals end up being labeled as sex offenders, which is an avoidable result. A real-life example is of a young male who ran away from home. His mother called the police in hopes of finding her son. As the officers returned the young man to his home, the young man proceeded to grope a female officer present at the scene. He was then arrested. On further evaluation by a psychologist, the young man was found to have undiagnosed autism.
In higher-functioning autistic individuals, families tolerate, compensate, and make up for the behavioral deficiencies. This strategy typically works until the individual considers going off to college, which is when the family attempts to seek help. Ideally, the individual should have received therapeutic tools much earlier in life.
Once a child is diagnosed with autism, or suspected to be autistic, a provider can screen for these types of sensory behaviors. The good news is there are treatment options. Occupational and behavioral therapies can address these behaviors with redirection. The appropriate therapists would need to have experience treating autistic individuals. In the case of inappropriate touching, sex education is key to mitigating these problems in teenage and preteen individuals with autism.
As providers, we are frequently in the best position to assist families with issues they may find embarrassing. Given our relationship, families feel more comfortable discussing these situations. Inappropriate or undesired behaviors can be screened for as early as the toddler stage. Oversight can lead to unfortunate outcomes. With the right support, autistic individuals can thrive and become independent. With some awareness as providers, we can really make a difference in the life of an individual with autism and their families.
Maria Mba Wright is a pediatrician.
