For many autistic people, the world can feel like a symphony of sensations: sometimes beautiful, sometimes overwhelming.
Sounds, lights, textures and smells can feel much stronger, or much softer, than they do for others. Understanding these sensory differences helps create spaces where autistic people can feel comfortable and thrive. Many autistic people are also more sensitive to medication, which matters for anyone considering treatment. This guide covers both, and where to find support in Wahroonga and beyond.
At a glance
- Sensory differences are a core part of autism, and can involve any sense, including signals from inside the body.
- People can be over-responsive, under-responsive or both, and it can change with stress and tiredness.
- Autistic people may be more sensitive to medication side effects, so a “start low, go slow” approach is often recommended.
Understanding sensory differences
Sensory differences are so common in autism that they’re part of how autism is described in the diagnostic manual (DSM-5-TR).[1] They can affect any sense. Some people are over-responsive, so input feels too strong. Others are under-responsive, so they notice less or seek out more. Many people are a mix, and it can change from day to day, especially with stress or tiredness.
When there’s too much input, sensory overload can cause stress, anxiety, shutdown or even physical pain. Here are some examples of how differences can show up:
| Sense | Over-responsive | Under-responsive |
|---|---|---|
| Sight | Bright or flickering light feels harsh; busy spaces can look fragmented or overwhelming. | May miss visual details, or seek out bright lights, colours or movement. |
| Sound | Everyday noise feels much louder; hard to filter background sounds. | May not respond to some sounds, or enjoy loud noise and music. |
| Smell | Smells feel intense or overpowering. | May not notice strong smells. |
| Taste | Strong flavours or textures feel unpleasant, so the range of foods eaten may be small. | May seek strong or spicy flavours. Rarely, mouthing or eating non-food items (pica), which needs medical advice. |
| Touch | Certain textures, labels or light touch can feel uncomfortable or even painful. | May have a high pain threshold, or seek deep pressure. |
| Balancevestibular | Motion sickness; movement activities can feel unsettling. | May seek movement, such as spinning, rocking or swinging. |
| Body awarenessproprioception | Fine motor tasks can be harder. | May stand close to others, bump into things or use more force than intended. |
| Inner body signalsinteroception | Body signals like hunger or a racing heart can feel overwhelming. | May not notice hunger, thirst, pain, needing the toilet or emotions until they’re strong. |
Synaesthesia
Some people experience synaesthesia, where senses blend together, such as seeing colours when hearing music. One study found it was almost three times more common in autistic adults (about 19%) than in non-autistic adults (about 7%).[2]
Noticing inner body signals is closely linked to understanding emotions. Read more in When Feelings Don’t Have Words: Understanding Alexithymia.
Creating sensory-friendly spaces
- Be aware. Notice possible triggers, like fluorescent lights, background noise, strong smells or crowds.
- Be creative. Add positive sensory experiences: soft lighting, a quiet corner, fidgets, movement breaks or a favourite texture.
- Be prepared. Let people know what to expect before new places or events, so they can plan, and bring headphones or sunglasses if helpful.
- Ask, don’t assume. Every autistic person’s sensory profile is different. The best guide is the person themselves.
Autism and medication sensitivity
Research suggests autistic people can respond differently to psychiatric medications, such as those used for anxiety, depression or sleep. A 2022 review noted that autistic children “tend to be more sensitive to medication effects and more likely to have adverse effects”, and recommended starting at lower doses and adjusting more slowly.[3]
What can be different
- Stronger effects. A typical dose may have a bigger impact.
- More side effects. Side effects may be more common or more intense.
- Unexpected reactions. Sometimes a medication can have an unusual or even opposite effect, such as a calming medication causing agitation. A clinical report from the American Academy of Pediatrics notes these “atypical medication responses may be more common”.[4]
Why it might happen
- Genes. Genetic differences affect how the body processes medication. Early research is exploring whether genetic testing could help prevent side effects in autistic adults.[5]
- Sensory awareness. Heightened senses may make side effects more noticeable.
- Other health conditions and the medications used for them.
- Communication. It can be harder to describe how a medication feels, so side effects may be missed.
The evidence for some medications is also limited. For example, a Cochrane review found no evidence that SSRI antidepressants helped autistic children, and emerging evidence of harm. Evidence in adults was limited.[6] And in a 2024 survey of parents of autistic children and adults, about 73% rated their family member’s medication as only partly effective. The authors called for clearer information for families.[7]
Good questions to ask your doctor
- Can we “start low and go slow”?
- Here’s how I (or my child) reacted to medications in the past. How might that affect this one?
- What side effects should I watch for, and what should I do if I notice them?
- How will we check if it’s helping?
- Do you have experience prescribing for autistic people?
Psychologists don’t prescribe medication. With your permission, we’re happy to work alongside your GP, paediatrician or psychiatrist.
Finding support in Wahroonga
A psychologist experienced with autism can help you or your child understand your sensory profile and build a life that fits. At Psychcare, we offer:
- Comprehensive assessments. Neuro-affirming autism assessments, including AuDHD, for children, teens and adults.
- Tailored therapy. Neuro-affirming therapy for sensory overwhelm, anxiety, burnout and self-understanding.
- Practical guidance on sensory-friendly routines at home, school and work.
- Support for families and children and teens.
Our Wahroonga clinic has a quiet, low-sensory waiting room, and telehealth is available if travel or new places feel like too much. See our clinic location.
Other helpful supports
- Occupational therapy
- Speech pathology
- Noise-cancelling headphones
- Sunglasses or tinted lenses
- Weighted or textured items
- Quiet spaces and breaks
Occupational therapists can help with sensory needs. Research on some sensory programs is still limited, so it’s worth asking about goals and evidence. For autistic-led information, Reframing Autism offers free resources, courses, a podcast and a welcome pack.
Common questions
Can you have sensory differences without being autistic?
Yes. Sensory differences are also common in ADHD, anxiety and other conditions, and some people are simply more sensitive. If sensory differences come with other autistic traits, an assessment can help.
Can sensory sensitivities change over time?
Yes. They can shift with age, stress, tiredness, illness and hormones. Many people notice they’re more sensitive when they’re already overwhelmed.
Does a psychologist prescribe medication?
No. Psychologists don’t prescribe. We can help you track how you’re going and, with your permission, share information with your GP, paediatrician or psychiatrist.
Is sensory overload the same as a meltdown?
Not exactly. Sensory overload can lead to a meltdown or shutdown, which are involuntary responses to overwhelm, not bad behaviour. Reducing sensory load and offering a calm space usually helps most.
Keep reading
You’re not alone. We’re here to help.
If you or someone you love is navigating autism and sensory differences, we can help you understand what’s going on and find support that fits. Book online, call us, or start with a free 15-minute chat.
(02) 9037 3509Suite 4 & 5, 5 Redleaf Avenue, Wahroonga NSW 2076. Telehealth Australia-wide. Psychcare is not an emergency service. If you or someone you know is in immediate danger, call 000 or contact Lifeline on 13 11 14.
Sources
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
- Baron-Cohen, S., Johnson, D., Asher, J., Wheelwright, S., Fisher, S. E., Gregersen, P. K., & Allison, C. (2013). Is synaesthesia more common in autism? Molecular Autism, 4, 40.
- Aishworiya, R., Valica, T., Hagerman, R., & Restrepo, B. (2022). An update on psychopharmacological treatment of autism spectrum disorder. Neurotherapeutics, 19(1), 248–262.
- Chun, T. H., Mace, S. E., Katz, E. R., & American Academy of Pediatrics Committee on Pediatric Emergency Medicine. (2016). Evaluation and management of children with acute mental health or behavioral problems. Part II: Recognition of clinically challenging mental health related conditions presenting with medical or uncertain symptoms. Pediatrics, 138(3), e20161573.
- de Miguel, L., Ballester, P., Egoavil, C., et al. (2023). Pharmacogenetics may prevent psychotropic adverse events in autism spectrum disorder: An observational pilot study. Pharmaceuticals, 16(10), 1496.
- Williams, K., Brignell, A., Randall, M., Silove, N., & Hazell, P. (2013). Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, (8), CD004677.
- Stojanovska, I., Chatterjee, A., Syed, Y. A., & Trajkovski, V. (2024). The utilization of psychopharmacological treatments for individuals with autism spectrum disorder (ASD) in a middle-income European country. Research in Autism Spectrum Disorders, 111, 102329.
This article is general information, not personal clinical or medical advice. Always talk to your doctor before starting, stopping or changing medication.