Medical Alert

• ASK whether lights, sounds, smells, are OK.
• Make lighting dim or subdued natural – no flicker or glare.
• Quiet please – no slams, hums, or beeps.
• Remove ALL scents (perfumes and in deodorant & soaps).
• Please, no cold, rough surfaces, or alarming touch.

Background

Almost half of us on the autism spectrum are painfully sensitive to sensations of one kind or another. This can lead to disorienting or debilitating sensory overload, shutting down our ability to communicate, and making a routine visit to a doctor or hospital nightmarish. Fortunately, there are many things you can do to make our visit better.

First, please ask if anything in the room is causing discomfort, and read any notes I have written for you. Be aware that many of us have difficulty identifying and stating what is bothering us. By adulthood, most of us have a growing awareness of what causes discomfort and we can tell you. Others of us, though, know, but can’t easily describe what’s awry. We need you to be patient. Ask me whether it would be easier to communicate in writing, or in less light. Here are some common problems and what can help.

Reduce the Intensity of Sensations

Light: It’s too bright, too fake, and flickers too much.

Please use subdued natural light where possible and avoid bright artificial lights. Where possible reduce: point lights in the dark, glaring lights, flickering images on monitors, fluorescent lights, whirling fan blades and garish colors or patterns. Window blinds that make bright lines are bad. Also, I’m not a shifty malcontent: It’s just that sometimes eye contact with strangers feels like staring into the sun!

Sound: I hear everything.

Please don’t make sudden or unexpected noises. Where possible, reduce high‐pitched sounds; constant hums (as from refrigerators); muffled voices through walls; non‐natural light sounds (like ticks and beeps); jumbled sounds that are hard to separate; the TV in the waiting room next door. Any of these can be excruciating. Volume is not always the issue: Small non‐natural sounds can be more painful than loud ones.

Smell: Your scents make no sense.

Many of us would rather smell any natural odor than any perfume. The smelliest bathroom is better than the “freshest” air freshener. Perfumed detergent residues on clothing, hand soaps, hand and face lotions, mouthwash, colognes, and deodorants – all those scents overwhelm us at best and make us ill at worst. Let there be fresh air!

Taste: The medicine tastes better without the fake candy flavor.

Try a natural flavor is one if absolutely needed. Texture can be a problem, too: Is the medicine available in another form? I may not tolerate certain tastes, like citrus. This can cause nutrition problems as well. Telling me to “Eat more vegetables” doesn’t help if the taste makes me nauseous.

Touch: Don’t stab me with that cloth!

Non‐soft fabrics, seams and labels, cold instruments, unexpected touch and sometimes any touch at all – all of these can be unbearable. Please keep the room at a moderate temperature.

Reduce the Number of Sensations

I don’t do “sensory multitasking” well. If you want to communicate with me it can help to reduce the number of sense modes involved. Here are some strategies to do this:

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Communicate without sound.

• In writing – via paper, iPad, keyboard or the like.
• With pictures, if it feels welcome.
• In silence I don’t have to interpret your vocal intonation or control mine.

Communicate without light.

• Through quiet speech in near‐darkness.
• In darkness I don’t have to interpret your body language and facial expression, or regulate mine. On the other hand, I may need some light to see your lips, to help me understand what you’re saying.

Reduce the “bandwidth”.

• Allow room for silence in conversation.
• Communicate one‐on‐one, not in groups.
• Speak calmly with fairly even tone and without condescension.

All of these suggestions will be wrong for some people. Improvise!

Sensitivities can vary. Some days I can tolerate what on other days I cannot. I’m usually more sensitive when I feel bad – like when I’m sick! I am not making the sensitivities up: It means I change daily like most people, and the effects are cumulative. Very often I am at the mercy of my environment. Please help remove the causes of the debilitating sensations! I am grateful for your aid.

I know that the world cannot always adjust to my sensory needs, and sometimes I just mask as much as I can. One other way you can help is to accept and support my personal accommodations, even though they may look strange. (See picture above.) I am a person whose senses are exquisitely sensitive. The same sensitivities might let me see in the dark and be an extraordinary audio tech.

Thank you for your help and understanding!