Sunday, August 14, 2011

Autistic and Barefoot

I have a theory,

Not often do the two halves of my life come together.  Usually (well here anyway) I am a barefoot runner OR I am a Mummy.  Generally it's pretty fixed.  Until, I started thinking.

As you are all well aware, my son has a form of Autism, which involves a lot of  sensory integration issues.  He has sensory issues in pretty much all of the senses. One of his biggest hurdles is how he marries his tactile, proprioceptive and vestibular senses.  These senses deal with how we perceive our arms, legs, body etc in our environment.  It's how we take these signals from our eyes, hands, feet, skin, ears/gravity and interpret them so we can stand up, walk in a straight line and not bash into anything.

When people have issues with these senses it can be seen in a number of ways.  Sensitivity to clothing, inability to stand up straight, falling over, spinning, a craving for deep pressure.  They may also deliberately bash into objects, prefer small cramped space to get sensory input BUT at the same time hate a scratchy sock or shirt. They have difficulty holding a pencil, putting on clothes, sitting still and climbing.  How children and adults react to these sensitivities are all based on them. Everyone is unique.  You unfortunately have to work it out yourself.

To get a clear idea of who we are dealing with, here is D's sensory profile:
Visual hyper-sensitive (see's everything, unable to filter)
Auditory hypersensitive (hears everything, unable to filter)
Gustatory hypo-sensitive (prefers bland, hard foods, limited diet)
Olfactory hyper-sensitive (very sharp sense of smell)
Tactile hyper-sensitive to light touch (so dislikes tight clothing, will jump and sudden touch) 
Proprioceptively hypo-sensitive - possibly.  Hyper and hypo sensitivity have similar traits so it's  hard to tell.  However he is sensory seeking in this area. He seeks deep pressure (high pain threshold, likes rough-housing, self-injures, self-stims, poor body awareness)
Vestibular hyper-sensitive.  (Clumsy, poor balance, craves movement. Doesn't get dizzy, has difficulty self-calming)

So I watched and observed.  I noticed that D seemed more "stable" at home.  Outside, he always seemed to trip up or fall over and even his Occupational Therapist mentioned he had balance/crossing midline issues on her evaluation.  He also seemed calmer.  This could be due to the "quieter" environment at home, but could it be due to something more?

I couldn't understand why he was better at home and then I realized at home he was always barefoot. Could it be that simple?

It made sense in some ways.  Most of our sensory input comes from our feet.  The input from our feet is fundamental in telling us how we are connected to the world.  I asked friends who had dealings with children with sensory issues.  They all seemed to say that the children they dealt with seemed to have a certain "reaction" in regards to the input of their feet.  They can either HATE the feel of the floor, or were calmer when they were barefoot OR had stimulation on their feet.  Just "google" "Sensory issues, Autism and feet" and you get one of two responses.  Either the children need super tight socks and shoes or they rip their shoes off and need to go barefoot.  

As I researched this topic more I discovered that Proprioceptive input can decrease hyper-active responses from other sensations. The book "Building Bridges" by "Yack, Aquilla and Sutton" cite an article by "Wilbarger, Williams and Shellenberger"  that states:
"Certain types of proprioceptive sensations can help the brain regulate arousal states.  Proprioceptive sensations rarely overload the nervous system and some sensations can have both calming and alerting abilities depending on the individual nervous system."

Wilbarger is responsible for the "Wilbarger Brushing technique" which has been used by Occupational Therapists to regulate Sensory Integration in children.

The Proprioceptive sense is how our bodies interpret touch.  Could the increased input through the feet gained form being barefoot be used to help D calm himself?

Obviously D was in the camp of wanting to rip off his socks and shoes.  However, we do not live in a society where going barefoot is considered acceptable.  In schools, Malls, or any public building you need to wear shoes.  Also Children who need sensory pressure, also have very high pain thresholds.  I know this is the case with D.  Keeping him barefoot, will not solve his problem of looking where he was going and lifting his feet if he steps on something sharp.  I have spent an evening picking splinters out of the bottom of his feet because he ran onto bark chipping and didn't feel the splinters until later that night when they were imbedded.  So how did I marry all of these problems? Minimalist shoes!

Unfortunately being in Canada, I have no easy access to minimalist shoes in a children's size.  I could order them, but as D is super picky I didn't want to spend hundreds of dollars on shoes he may hate the feel/look/shape of.  The beauty of Autism is that once their minds are made up it's hard to break the pattern.  The only decent minimalist shoes I could find were the child's sized VFF's.  As he is a child that can't find his fingers to put on gloves, I didn't want to risk my sanity.  In the end, I decided to go and buy a pair of $10 water pool shoes.  It was only an experiment right?

But then I tried it.  With no real expectations except idol curiosity, I discovered that this was something he needed.  Within hours, he was claiming these were the most comfortable shoes he had worn.  Within days, he was climbing and climbing with confidence.  Within a week, he refused to wear anything else. 

[Edit: My husband is more of a skeptic than me.  He accepts my barefoot/minimal running as one of my quirks, but he isn't a convert.  However, even he commented that when D was in his water shoes, he was able to climb and run with more stability.]

This is a situation where I wished I had the foresight to take video of him before I switched his shoes.  Now I can't take him out of his falling apart $10 pair of water shoes.  However, I do have "after" video of him showing us his new climbing moves and telling us what he likes about his shoes.

Yes, I know I am coming to this topic with an element of bias.  As a barefoot runner and advocate I AM going to say being barefoot is best. So, I would love to know from others who may work/live with children with sensory issues.  Is this something you have experienced, or may think it explains your child's behaviour?  Are we onto something?  Obviously going barefoot or minimalist is not the cure for sensory integration or Autism - however, if it can provide the sensory feedback these children need it can't be a bad thing.

I am not a Behavioural Consultant, Occupational Therapist or a Doctor.  I am a Mum how is largely self-taught on Autism.  So I would also be interested if anyone has any medical research on this.  I have tried searching on the internet.  Although I have found a lot of antidotal information I haven't found any documented studies.  If you are in the medical profession and this is an area of research you could be interested in, then please let me know - I will happily try and help.


  1. I'm so happy the water shoes are working for him!! This is a great explanation of so many topics at once. You're a great writer!

  2. Awesome. What else is there to say? :^)

  3. Yep, what PegHead said ;)
    Fascinating stuff!

  4. Starting last week, Nat has REFUSED to wear shoes -- screams, yells, simply won't put them on. Once or twice he's wanted to go on a walk with me badly enough to put them on, but he's pretty much resigned himself to being in the stroller for walks (and we've resigned ourselves to his being barefoot at the playground, and just trying to keep an eye out for broken glass!) Tried some toddler crocks, thinking they'd he less tight and closed, but he hates them. Maybe we'll try some aqua shoes and see what the reaction is.

    I was also thinking of seeing if Softstar makes a toddler shoe with their 2mm vibram sole, like for the RunAmoc. If not, they might be willing to do so, since they custom make almost everything. But like you said that's a pretty steep investment if the kid decides he hates them . . . I'll let you know if we get any experience to share . . .

  5. Fascinating post Katie. What a great mom (mum) you are to put it all together and have it work out so well.

  6. Hi, I know this is a year later, but i just found this post and found it interesting. I have autism (HFA) and am the same as your son, i crave deep pressure. Recently I have been taking evening walks down the the beach barefoot enjoying the different textures of the pavement (sidewalk), wet sand, dry sand and sea. I find it really relaxing. Obviously this isn't going to work for everyone, but as an autistic who dislikes shoes and socks it's nice to have found that I can walk barefoot and get double the enjoyment (no horrid shoes + feeling what i'm walking on)

  7. I also have autism, and I like to wear either really heavy, tight mountain boots (yes, the ones no-one ever wants to wear because they are too heavy and too ugly), Or I like to go bare-foot, which is usually not accepted where I go.
    I do have the issue that I don't like dry terrain, they have to be of a specific consistency and dryness., it depends on the type of surface actually. And then I do like both feet equally dry (or wet), which means I can't walk with one foot in the grass and one on the pavement. It is hard to walk somewhere bare-footed, and see a more difficult type of pavement ahead which I have to cross. But otherwise I like it a lot.