MGH Home SchoolPsychiatry Home Page
School-Based Interventions : Autism Spectrum Disorders
Interventions for Sensory Issues

  1. Prepare the student for transitions and deviations from regular routine in order to minimize overstimulation or anxiety caused by a change in the schedule or routine

    Tell the student what to expect: who will be there, what will happen, how long it will last. If needed, use a visual (list, picture schedule) to ensure the student understands what is happening and what you are saying.
  2. Develop a list of calming and/or stimulating activities and sensory choices for the student to use when over or under-stimulated

    If the student likes music, allow him/her to listen to certain calming songs when over-aroused. Student-developed sensory choices can also be used as rewards following on-task behavior.
  3. To control sensory inputs, allow the student to be first or last in line or to leave class early

    Allow the student to change classes five minutes before the other students, or have him/her hold the door open for other students and then join the end of the line as the "caboose."
  4. If the student is disruptive due to over-stimulation, move him/her away from the source of stimulation

    Prior to over-stimulation, with the student, agree upon quiet spots for retreat and regrouping. Equip the space with beanbag chairs, big pillows or favorite books. At lunch, assign quiet lunch with a counselor or have assigned seating at the perimeter of the lunchroom.
  5. Teach students who use distracting vocalizations or other self-stimulating behaviors to employ other acceptable (less intrusive to others) vocalizations or behaviors

    Practice humming loudly and softly and have the student role-play appropriate times to hum loudly and appropriate times to hum softly.
  6. Use ear plugs or headphones to diminish auditory stimulation

    Allow the student to wear portable CD player earphones (more socially acceptable than earplugs) to reduce background noises during an assembly, bus rides, gym, or recess.
  7. Use leading questions or pictures to help the student articulate and identify over-stimulating emotions and situations

    "Did you feel angry at school today?", or "did you feel disappointed?". If needed, use a pictorial dictionary of feelings (a feelings poster containing a series of faces depicting emotions that act as prompts to help students find appropriate language to describe feelings).
  8. Teach simple stress management techniques and relaxation activities

    Encourage the student to listen to appropriate music, do deep breathing, think positive thoughts, or use the computer.
  9. Follow instructional work with opportunities to release energy

    Have a specific and somewhat private space where rocking or jumping can occur without disrupting others or attracting undue attention. Highlight a stopping time (with a timer) and clarify the next activity on the schedule.
  10. Use visual/picture supports in the form of "rule charts" and directions during distressing, recurring tasks to support the student's self-regulation

    If the student is upset with fire alarms, post the "fire alarm procedure." Have the student review it daily to make sure that he/she knows what to do in the case of an alarm.
  11. Use visual supports to prepare the student for changes that typically lead to sensory overload and escalations

    Use a mini-calendar to help with planned changes. The last item on the calendar can be a transition cue so the student knows what to do and where to go next. Write a note to the student to explain any changes in the schedule ("we usually go to recess after lunch, but today we are going to stay in the classroom after lunch"). top

Specialized Instruction

  • Identify and diminish sensory contributions to disruptive behavior

    If the student is not in a condition to listen, learn, work or communicate: stop talking, reduce auditory stimulation, and provide printed words/line drawings to clarify instructions.
  • Use written and pictorial formats to document group and individual routines/schedules in order to minimize sensory issues related to changes in the routine or schedule

    Use an individually designed calendar to visually represent events and times. Review the calendar consistently each morning and reference it throughout day.
  • Allow the student to do "heavy work" before sitting down

    "Heavy work" includes pushing, lifting, pulling, stair climbing, or carrying books.
  • Give relaxing/solitary activities to reduce pent-up anxiety

    Allow the student to work on a solitary item of his/her choice (computer, reading a book) 30 minutes prior to school dismissal.
  • Diminish sensory overload by practicing handling stressful feelings through role-plays, stories, puppets, or drama

    Role-play with the student via puppets, skits, scripts, or scenario situations where self-monitoring statements are used, such as "I am furious. But if I keep my temper under control at school, I will be able to use the computer after school."
  • Devise a self-control routine for the student to ask for and take a break when he/she feels "over-loaded"

    Insert a break into routines to relieve frustration or tension. The break can be as simple as "take five" (minutes) to get a drink, or look out the window for a few minutes before continuing the task.
  • To minimize sensory over-load, systematically configure for major transitions (changing schools, teachers)

    Allow the student to create a photo album of new and old teachers and friends. Accompany the photo album with a "social story" depicting transitions. Click here for sample social stories:
  • Teach the student to identify when he/she is over-loaded and how to self-regulate

    Teach the student that when neck and shoulder muscles tense up, the body is signaling it is overloaded. "Take five deep, slow breaths, and push your shoulders down and back like a dancer." Provide a quiet space where the student can go in the classroom (mat, rocking chair, or bean bag chair). top

Behavioral Planning

  • Explicitly state and model examples of desired, acceptable behaviors when sensory issues escalate

    Speak positively and tell the student what to do. ("Please sit in the chair until I finish eating my carrots" rather than "don't get out of that chair")
  • Identify signs of sensory distress - raising voice, shaking shoulders, pacing - and establish a hierarchy of student responses to

    When the student's voice gets louder, the student will breathe deeply three times and go to the bean bag chair to relax. top
    ©2010 Massachusetts General Hospital, School Psychiatry Program and MADI Resource Center
    Copyright | Disclaimer | Privacy Policy | Department of Psychiatry  | Site Map