Recognising and preventing sensory overload

Recognising triggers

In its chapter on crisis intervention, the guideline described that triggers can be hard to recognise for untrained people, for example light touch, communication problems, sensory overload or changes in routine. ^{[1, Ch. C.8]} It named a behavioural analysis, that is, observing together when something becomes difficult and what happened beforehand, as the basis for targeted help. ^{[1, Rec. 104]} Keeping a trigger diary is a practical idea from the editorial team, not a recommendation of the guideline.

What the 2021 guideline named for everyday life

• Reduce stimuli: According to the guideline, helpful approaches include avoiding strong sensory stimuli (noise, smell, light), maintaining physical distance, structuring the environment and routines, and concrete, direct communication. ^{[1, Rec. 3]}
• Structure daily life to avoid disturbing stimuli: For preschool children, the guideline named structuring daily life to avoid disturbing stimuli as part of parent training. ^{[1, Rec. 23]}
• Avoid under- and over-demand. ^{[1, Rec. 3]}

School, work and housing

• School and nursery: As reasonable adjustments, the guideline named, among other things, an individually designed workspace, a low-stimulus separate room where needed, and hearing protection. ^{[1, Rec. 109]} More: Reasonable adjustments at school.
• Work (section for people without intellectual disability who do not gain a foothold in the open labour market): before starting work, hypo- and hypersensitivities should be asked about and taken into account; a consistent workplace, breaks for recovery and a well-structured workplace were also named. ^{[1, Rec. 114]} More: Work and career.
• Housing: For supported housing, the guideline named reducing stimuli and places to withdraw where needed. ^{[1, Rec. 117]} More: Living with autism.

Caution with “toughening up”

For toddlers and preschool children with strong over- or under-sensitivity, the guideline (grade 0, “may”) named as an option an age- and development-appropriate exposure (gradual getting used to stimuli) guided by behavioural therapists, which parents can supplement at home. ^{[1, Rec. 23]} At the same time, it stated that when carried out correctly no undesirable effects are known, but that these have rarely been studied systematically. The self-advocacy association Aspies e.V. pointed out in the guideline that exposure sometimes does not lead to desensitisation but to mere habituation to enduring, which costs strength and resources. ^{[1, Rec. 27]} This needs to be weighed up; exposure should not be attempted without professional guidance.

What else you should know

• Signs of overload are individual. The article Sensory processing provides information on meltdown and withdrawal.
• Aids such as hearing protection are named in the guideline as an example for school; this article makes no statements about products or their effect.
• Not covered: effectiveness of individual aids (headphones, weighted blankets, glasses) and sensory integration therapy in detail. According to the guideline, a small pilot study on sensory integration therapy found an improvement in individual goals but no clear effect on sensory behaviours. ^{[1, Ch. C.4.3.2]}

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Empf. 3, 23, 27, 104, 109, 114, 117; Kap. C.4.3.2, C.8). – Guideline (in German); expired on 23 March 2026 (see no. 2)
2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)