The final criterion of Section B of the DSM V involves sensory issues.
Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment.
These vary a lot from individual to individual, but I haven’t run across anyone autistic yet who doesn’t struggle with sensory input to some degree. Personally, I have a mix of hyper and hypo sensitivities, but it’s taken a while for me to identify them. I’ve lived with them so long and adapted where I could so thoroughly that I didn’t even think of them as sensory input issues, per se.
Let’s start with the most obvious. I’m very hypersensitive to light and visual input. I wear sunglasses on cloudy days, dusk, and other conditions where most people don’t. And bright light always hurts even through sunglasses, squinted eyes, and a hat brim. If I have to spend an extended period in bright light with no sunglasses, I will develop a stabbing headache. I’m also not fond of the flickering of fluorescent lights and headlights when driving at night blind me and are painful. I’ve learned to look at the painted markings on the road to steer where possible. If there’s too much happening visually it can be hard to focus and visual input will distract me. I can’t talk on the phone while the TV is on. I have to close my eyes or turn away.
I’m both hypo and hyper reactive to sound. I have a tendency to tune sound out and I don’t process verbal information particularly well on first hearing. At the same time, I’m easily distracted by sounds and have difficulty filtering them out when, for instance, trying to work in the office or have a conversation in a restaurant. At work, I’ve used headphones since the early days of the walkman in the 80s.
I’m also hypo and hyper reactive to taste. A few things would make me gag in the past, notably what my diagnostician called ‘silky firm’ textures like mushrooms and tofu. I’ve since trained myself so I can eat them, though I wouldn’t say I really like them. But I also seek out strong flavors. As a child, I would eat whole lemons, rind and all, for the strong sour taste. (Actually, even as an adult, I would squeeze lemon into my tea and then eat the whole slice. I shocked my wife doing that on an early date.) I would also snack on a bowl of iceberg lettuce doused in red wine vinegar. I craved spicy, hot food as well and have always eaten the hottest things I could find. Once, as a ‘joke’, some other kids at a camp brought me back pizza with red pepper flakes piled under the toppings. They were disappointed when I didn’t even notice.
I didn’t think there was anything unusual about my clothing. Sure, I like clothes with no tags and have cut them out plenty of times, but doesn’t everyone? Tags are annoying. But after my initial assessment, I took stock of my wardrobe and realized pretty much everything I owned was 100% cotton, loose, and comfortable to the touch. I had to write my diagnostician back and tell her I had apparently unconsciously compensated for my sensitivity to harsher fabrics by never buying or wearing them. At the same time, I’m also pretty insensitive to changes in the surrounding temperature. I prefer cold to hot, but I’ve been known to wear shorts when others are freezing.
I mostly worked out ways to manage my sensory issues and they aren’t as severe as the ones some people have. But they are definitely an ever present part of my life.