autism personal space

Autism: Don’t Stand So Close to Me

autism personal spacePicture this: you respond to a call for a 26 y/o male “not acting right” (that’s about the extent of information WE get from dispatch, anyway ;) ). You arrive on scene and are immediately approached by a 5’9” 230-lb male who won’t make eye contact or respond to his name. He proceeds to get too close, won’t slow down or stop on your command, and maybe even reaches out and tries to touch your arm.

As an EMS provider or law enforcement officer, this situation would immediately be perceived as an aggressive threat and could go south very fast.

Regarding body proximity, responders are often faced with the reactionary gap – the human factors formula that compares action vs. reaction – when assessing situations like this on scene. The closer an assailant is to you, the less time you have to defensively react to any aggressive behaviors or actions.

When an emergency responder experiences a threat, it takes on average .58 seconds to assess and determine if the threat is real, then an additional .56 to 1.0 seconds to make a response decision. We as providers have to fall upon one of five possible responses to threat: defend, disengage, posture, hyper-vigilance or submission. I’m sure you can figure out which one most public safety professionals embrace.

So what if the person was autistic? What if they didn’t understand where their body ends and space begins? What if body proximity, spatial awareness and proprioceptive dysfunction came into play and they had no malicious intent and no idea their actions were perceived as threatening?

Does that mean you should leave yourself unprotected or allow these behaviors on scene? Of course not. But let me explain.

There are four main categories of proxemics:

  • Intimate Distance (touching to 2 ft)
  • Personal Distance (2-4 ft)
  • Social Distance (4-12 ft)
  • Public Distance (>12 ft)

Although seemingly effortless to most people, judging the right distance to stand from someone is a complex and dynamic skill. It can depend on many factors, such as your relationship to the other person, your age, gender, emotions, and culture. Your body proximity is a form of nonverbal communication that, in turn, says a lot to another person.  Standing too close to someone can absolutely communicate aggression.

Why This Is an Issue

The Autism Genetic Resource Exchange (AGRE) compared the scores of 766 children with autism against 766 of their unaffected brothers and sisters on a questionnaire of autistic social behaviors. An overwhelming 79 percent of autistic children “were less aware of being too close and more prone to personal space invasions” than their neurotypical siblings.  Though it seemed to improve with age, it continued to affect teenagers and young adults. Those with spatial issues were more likely to:

  • Stand too close to others
  • Touch others in an unusual or inappropriate way
  • Walk in between two people who are talking
  • Be unaware they are talking too loudly or making too much noise

This behavior is often done on automatic pilot and not self-monitored.

Proprioception and Spatial Awareness

Proprioception refers to the sensory input and feedback that tells us about movement and body position. “Receptors” are located within our muscles, joints, ligaments, tendons, and connective tissues.

If this proprioceptive sense is not receiving or interpreting input correctly it is referred to as PROPRIOCEPTIVE DYSFUNCTION.

Spatial awareness is part of our overall perception. Since perception is the organization and interpretation of sensory stimuli from our environment, autistic people would need to have adequate body awareness to be able to form the relationship of their body with the stimuli and objects within that space.

My son has tremendous struggles when it comes to this. Not only does he have to constantly touch the wall when walking in public, he perpetually “hovers,” stands too close to people, touches them without invitation, and even crashes into them. This is due to his nervous system craving proprioceptive input and his inability to fully perceive where he is in relationship to his surroundings. At home, we use a hula-hoop to continually demonstrate personal space. While he has made significant progress, it is something we must address daily.

What scares me is that my son is a BIG child. His simple lack of spatial awareness might cause him to be severely injured or incapacitated if his behaviors are misinterpreted, especially during a heated situation or crisis.

What Can You Do On Scene?

If you identify someone as autistic on scene, whether by the family’s information or from the tools you learned in my autism training, try to keep this information in the back of your mind during your scene size up. Know there is a possibility of someone being a ‘space invader’ and that it might not be an aggressive or threatening action.

I am not telling you to put your guard down and allow someone into your personal space AT ALL. But awareness goes a long way. When you start putting the picture together that someone might have spatial awareness issues or proprioception dysfunction, try putting your arm out and stating, “Stay at arm’s length.” Use clear, concise phrases that have only one meaning, such as “Stop there” while holding your arm out.

The combination of the visual cue and clear commands could truly go a long way in stopping a situation from being misinterpreted and rapidly escalating out of control.

Where Am I? Explaining Proprioception and Autism

What is it?

Proprioception , meaning “one’s own” and perception, is the sense of the relative position of parts of the body. Unlike the traditional five senses by which we perceive the outside world, proprioception tells you whether your body is moving or sitting still, as well as where your body parts are located in relation to one another.

Children with Autism frequently show signs of proprioceptive dysfunction. Do these sensory seeking behaviors sound like your child?

  • Loves to crash into walls repeatedly
  • Stomps when walking
  • Kicks the chair or hooks feet around chair when sitting
  • Prefers tight or multiple layers of clothing
  • Chews on fingers, pens, Nintendo DS styluses (I have bought many of these!)
  • Asks for and gives tight squeeze bear hugs
  • Bumps and pushes other children

Does your child also have difficulty with:

  • Regulating pressure when writing – writes too dark or light
  • Breaking toys
  • Using too much force, like slamming doors, squeezing objects, or setting them down forcefully
  • Petting animals too hard

Children with poor spatial orientation often walk with an odd gait, are unusually clumsy, and sometimes even lean to one side. Riding a bicycle is something they simply can’t get the hang of. They do not feel their bodies in relation to space, and as a result do not feel grounded or safe.

Gravity

According to Dr. Robert Melillo’s Disconnected Kids, a child can function normally without sight or sound, but will struggle immensely with any degree of proprioceptive dysfunction. We resist gravity using our large muscles and joints. In fact, gravity is such a strong stimulus that life cannot survive very long without it. Scientists have tested the effects of the lack of gravity on the brain, concluding that there is a rapid brain cell degeneration that occurs in outer space. NASA noted that some astronauts actually returned from space missions with sensory processing issues similar to children diagnosed with learning disabilities. That’s powerful.

Here’s another amazing test by scientists at the University of California at Berkley: when rats used their muscles and joints in new ways their brain plasticity increased. When sent into space, these same types of rats showed reverse plasticity and marked degeneration of the brain cells.

Help and Hope

So perhaps this illustrates a direct correlation between a sedentary routine (video games, computer use, television) and the continued struggle with proprioceptive dysfunction. Incorporating an Autism Fitness program into your child’s schedule along with specific sensory exercises designed to strengthen brain function can dramatically improve your child’s sensory processing function.

Melillo’s groundbreaking research and results show a disconnection between the left and right sides of the developing brain hemispheres as the underlying cause of Autism, ADHD, Dyslexia, and other PDDs. He has proven that the brain is not hardwired and can change with the right stimulation for the right amount of time, either with exercises done at home or through the Brain Balance Centers he founded.

Why Does My Autistic Child Scream?!

  • Being a “space invader”
  • Staring into lights
  • Self-stimming, such as rocking, spinning, banging head, humming, or screaming
  • Little or no eye contact
  • Picky eater (especially regarding textured foods)

Does your child display any of these “odd” behaviors? What we see as abnormal or sometimes even impish or difficult is usually related to the child’s attempt to calm their body or make sense of their environment through the sensory input they receive.

It has been documented that many children with ASD have difficulty processing sensory input. Normal sensory integration is taking information from your surroundings through your senses and sensory systems, including sight, smell, sound, touch, and spatial awareness (where your body ends and space begins). The information is processed in the brain and then interpreted, organized, and sent back to the body with instructions for an appropriate response.

What happens when it goes wrong?

Imagine being “under assault” by your senses 24 hours a day. In children whose sensory systems are not properly developed, this is what it’s like. Having a sensory processing disorder means you collect the input like anyone else, but when the data enters the brain it is not processed correctly and therefore the brain sends out inappropriate and abnormal responses.

Hyperesponsive is when the brain essentially short circuits from magnified or intense sensations. Even the lightest touch to a child can trigger a “fight or flight” response: the nervous system is perpetually on high alert and perceives nearly every movement or sensation as danger. Because of this, the child may avoid certain foods, clothing, movements, or perform repeated movements in attempt to calm the body.

Conversely, hyporesponsive is when the brain simply doesn’t register and respond to input received. A child may fall down or bang his or her head and not indicate any sensation of pain. In effort to make sense of their world, they may employ all other senses to compensate. A hyporesponsive child may not be able to tell if they are sitting straight in a chair or falling over. Imagine! They will also constantly touch walls, lean back in their chair, or feel countertops and surfaces to try and ground themselves.

What if I relate to both types?

You probably are saying to yourself that your child exhibits behaviors from both categories. Me, too! Most children with a sensory processing disorder are actually hyporesponsive to some input and hypereponsive to other types. For instance, if proprioceptive input is needed by the body they may jump or push things; if for vestibular input they may spin or rock, and for tactile input they might crave deep pressure. They also lack the ability to separate their experience/input from yours, so they will frequently do to others what their bodies are seeking (squeezing the dog, plowing into a parent holding hot coffee…).

Awareness and compassion – the first step

The bottom line is that children with sensory dysfunction cannot learn to function within their daily routine unless their surroundings make sense. To compensate, the brain either turns up or turns down the response, which results in the behaviors described above.

I have found that this kind of awareness can instantly turn my frustration into compassion when dealing with these behaviors. It also helps me help my son by recognizing the responses and asking him the right questions. This encourages him to describe what he is experiencing and teaches him to ask for what his body needs before it spins out of control.