Visual discomfort in autistic children

Autistic people commonly experience differences in sensory processing which can negatively affect quality of life and mental health. In particular, heightened reactivity to sensory information can result in discomfort, which can make certain spaces and activities (like attending medical settings) disabling. There is a widespread recognition that we need to make spaces and services more sensory-inclusive for autistic people, as reflected in policy and initiatives like quiet hours.

However, there is very little information about how to adapt sensory information to make it more comfortable for autistic individuals, without adversely affecting others.

This project will begin to provide this necessary information. We will systematically find out the precise sensory parameters that lead to visual discomfort in autistic participants, and whether this differs from typically developing individuals. We focus on the visual system as heightened visual reactivity in autism is currently poorly characterised, yet there is a well-established literature characterising visual discomfort in non-autistic populations which we can draw upon.

The project aims to uncover the general stimulus features underlying visual discomfort in autistic individuals, while taking account of individual differences. This will give a more precise characterisation of visual discomfort in autism, which will in turn allow us to uncover the underlying mechanisms.

We will work with a group of consultants with lived experience (e.g., autistic individuals and parents of autistic children) to guide the project. In the first part of the project, we will present autistic and typically developing children with a range of visual stimuli (including striped patterns, flickering videos and natural images), either in-person or online, and children will rate how uncomfortable they are.

The reason for working with children is that we are interested in how visual discomfort develops, and autistic individuals may 'get used' to sensory stimuli with age. We will identify the visual features that cause the most discomfort in autistic children and whether this differs from typically developing children, while taking account of individual differences.

We will also see whether discomfort ratings relate to parent-report and child-report questionnaires, to make links with everyday life and to help begin to understand why discomfort ratings might vary from person-to-person. In the second part of the project, we will take the most and least comfortable stimuli for autistic children and use these to link discomfort to brain activation using EEG (a technique which measures electrical activity at the scalp) and measures of arousal including heart-rate and pupil size.

These links will help us understand why autistic children experience more visual discomfort than typically developing children.

The project will precisely characterise heightened reactivity to visual information in autism and identify underlying mechanisms. The findings will inform how environments (e.g., patterns of carpets, building frontages) and visual materials (e.g., educational resources, websites) should be designed or adapted to minimise discomfort for autistic people.

We will create pathways to impact by holding knowledge exchange events with stakeholders (e.g., designers, architects, educational professionals). By minimising the uncomfortable stimuli that autistic individuals are exposed to, we have the potential to improve mental health and quality of life for autistic individuals. By additionally studying physiological mechanisms, we can link the sensory symptoms experienced by autistic people with underlying physiology, and may be able to develop nonverbal measures of discomfort which could ultimately be used with autistic individuals with few-to-no words.