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Temperature Regulation – Why Does My Autistic Child Refuse To Wear A Coat?

temperature regulationMany children and adults with Autism Spectrum Disorders experience a multitude of sensory symptoms. These sensory processing integration issues or sensory processing disorder (SPD) can include issues relating to temperature regulation. The person with Autism may not be able to adequately adapt to changing temperatures, and/or may not feel temperatures the same way a neuro-typical (NT), person without Autism, does.

What is Temperature Regulation?

Temperature regulation is an automated body system that regulates the body’s core temperature in response to outside stimuli. The temperature of the body is regulated by neural feedback mechanisms in the brain, which operate primarily through the hypothalamus. It has the remarkable capacity for regulating the body’s core temperature which keeps your body temperature somewhere between 98F and 100F. When your body is exposed to heat or cold conditions this system balances your internal temperature with the temperature outside.

Do People With Autism Have Difficulty With Temperature Regulation?

Children and adults with Autism Spectrum Disorders suffer from temperature regulation problems, sometimes as a part of overall sensory processing issues. They may exhibit hyper or hypo sensitivities to heat and cold. A manifestation of this is the child who does not feel cold in the winter and continuously peels off his clothing or coat despite the cold weather. The child who has difficulty cooling down after a short time in the sun may also begin to shiver after a brief period in air conditioning.

Adults and children with Autism may become overheated quickly when taking even moderately hot showers, feel dizzy, light-headed, or report seeing spots. They may need an extraordinary amount of time to cool down before resuming activities such as dressing and drying hair after the shower is complete. The same person may feel overheated, enter an air-conditioned room, and then begin to feel cold much more quickly than others around them. Is Temperature Regulation Part of Sensory Processing Disorder (SPD)?

Sensory Processing Disorder (SPD, formerly known as “sensory integration dysfunction”) is a condition that exists when sensory signals don’t get organized into appropriate responses. People with Autism commonly suffer from SPD, and temperature regulation issues are just one small aspect of the overall sensory processing system. In addition to becoming too hot or too cold too quickly, other evidence of temperature regulation issues in persons with Autism can include a strong preference to eating foods only at room temperature (not too hot or too cold). Children may refuse bathwater that is too warm insisting on tepid waters, or either extremely hot or cold waters.

Living with temperature regulation issues can put a person in a constant state of discomfort. They may be unable to sweat as other people do to cool down or may sweat too much for the perceived temperatures. The important thing to remember is that the person with Autism experiences temperature regulation issues and does not feel the temperatures in the same way that you do. What you may see as an extremely cold day, may actually feel warm to the person with an Autism Spectrum Disorder. This discomfort can lead to or contribute to sensory overload, shutdowns, and meltdowns.

Jeannie Davide-Rivera

Jeannie is an award-winning author, the Answers.com Autism Category Expert, contributes to Autism Parenting Magazine, and the Thinking Person's Guide to Autism. She lives in New York with her husband and four sons, on the autism spectrum.

16 Comments:

  1. Bingo! Finally an explanation! Diagnosed Asperger’s at age 47, and still finding things that explain why I do/am certain ways.
    I can be sitting in the summer sun sweating, the slightest touch or puff of moving air on my skin and my entire body gets goosebumps and I shiver like it’s below zero, taking several minutes to “warm up”. My feet are always cold, at times so cold they ache and consume every thought, yet they are soaking wet with sweat. Cold feet also over activates the already hyperreactive bladder, making the only thought “I need to pee….NOW!”
    On the flipside, it can be freezing cold, in a social setting, and I’m dripping sweat everywhere. Knowing you’re all sweaty makes you conscious of every glance or stare, which increases the self-consciousness, that rapidly escalates into a situation of embarrassment and shame, which only makes the sweating worse.
    Textures are also up there…touch, taste, smell…yes smells have palpable textures, and the wrong ones can cause meltdowns…my olefactory senses are unbelievably strong and sensitive.
    I’m not a fan of restaurants either….too many choices to decide, or what appeals has a “no no texture” in it and I have walked out, gone to 7/11 and dinner is a Mars bar….again.
    I’m glad to know I’m not the only one going through this confusing frustrating overwhelming world so many have no idea exists!

  2. Thank you for writing this article as my son is on the spectrum and he is constantly telling us that he is still cold even when he gets out of a hot shower. It’s difficult for us to understand but I know he definitely feels that way. His Dr laughed it off and made us feel funny for bringing it up but my son has an awful time feeling unbearably cold sometimes when the rest of us are warm.

  3. On the last point:Is Temperature Regulation Part of Sensory Processing Disorder (SPD)? It may also give febrile seizures(convulsions) in children. If it continues past 3 years it is epilepsy triggered by an inability to cope with a change in body temperature and the parent/carer will need specialist epilepsy training.

  4. I’m 25 and just found out that people with Autism suffer from temperature regulation problems. I can’t believe after all those years in school, no one ever suggested Autism to me or my parents when I have every common characteristic.

    I’m shocked to hear how accurately this article explains how I’ve been feeling all my life, while everyone around thinks I’m crazy for feeling like I’m on the verge of heatstroke when it’s 15 degrees celsius.

    Thank you for this article. I hope this is better understood and communicated in schools now.

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  7. I seem to have trouble determining whether I’m too hot or too cold. My unheated garage was probably 5°C. I was wearing a sweater and interestingly, even though my hands were too cold for dexterity and I was sluggish, I didn’t shiver at all. It probably took me hours to warm back up. My mother was concerned that I could develop arthritis.

    Studies say that a lack of sleep affects temperature regulation. Since up to 80% of autistic people have sleep problems, could that be ones of the causes? I hope there are proven ways to help autistics with insomnia to sleep well. I’ve tried magnesium, blackout curtains, white noise, exercising (on my commutes), F.lux, avoiding stimulants, and sunrise simulator. So far, my average sleep’s still between 5.5 and 6 hours.

  8. Mrs Morag E Donnachie

    So glad I found this. It explains a lot. I struggle with ambient temperature, I am seldom a comfortable temperature always either too hot or too cold but I love super hot baths (which my family thinks is crazy). Now I have an explanation for it. Thank you.

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  10. I’m so thankful I found this article. I’ve been asking doctors & therapists who work with my 2 y/o about this…She has a major issue with the sun & heat. The sun makes her sneeze its so weird & breaks her out it small red bumps quickly after being in the sun. After only 10 minutes outside on a warm day her face is blood red & she because extremely lethargic. And if riding in the car ( even with the a.c. on if the sun is shinning on her she will get sick & throw up. Lately every time she rides in the car for more than 30mins she gets car sick. I don’t think she sweats much & any just usually her hair, we had an awful time trying to collect sweat for the cystic fibrosis sweat test…that makes sense now! I keep getting told by her OT “oh that’s typical” She acts like my daughter doesn’t even have sensory issues, I have always felt its more than just SPD I’ve ALWAYS felt its some form of Autism because when I read things it makes sense of issues in having with her. I just don’t know why no one else SEES it?? But she is very different when we are out she’s more withdrawn, & watches everyone/everything. But she has had a few meltdowns at therapy like over showing the OT she could/ couldn’t put on clothes. I tried to explain to the OT she has an issue with anything related to her head, washing or fixing her hair, changing clothes especially her shirt…but she said its typical..no its not typical for a child to freak out over any of that not in my opinion. Its a battle to do all her ADL’s except getting her into the tub. Then after 3 hours its a battle to get her out. IDK if its because she’s extremely intelligent & usually cooperates with therapy or her OT just isn’t well trained in SPD. Because I’ve learned more on my own than weekly therapy. I also found out the problem my daughter has with never wanting to eat…she never says she’s hungry & rarely says she needs a drink, but i recently found that’s a sensory issue. Once again doctors & therapists never had any answer to what would make my child not feel hunger?? She ALWAYS says her bath is too hot even when its almost cold, she has NEVER slept covered up & absolutely won’t use a weighted blanket. Personally her intelligence at 2 almost 3 is what really makes me think Autism. The way she memorized EVERYTHING, the was she plays in her own world ignoring me for hours on end, the way she hates to be around ppl & if they say hi to her she screams & runs away, the way she flips out when anything is different, her tantrums ( which she’s had since an infant but now they want to say oh it’s because she’s 2), well now I’ve noticed when she’s really upset she gets in a panic & wants to go home..she flaps her hands repeating over & over I wanna go home & has even slapped me in the face with both hands. But looking back I think she was in the fight or flight state…this was over the OT adding the clothes exercise to her obstacle course which both were different than most times she’s been to therapy. She also flipped out when during her therapy another child got on the swing which was part of her obstacle course…then that child got off swing and onto trampoline another part ….she gets upset and throws herself in the floor usually gets hurt. As a single mother I’m doing all I know to do but i feel no one is helping learn how to help my child…how to stay calm..how to learn what to do before she get to that point so she doesn’t get hurt…I mean I read all I can but honestly I don’t have much time. I just want answers!! She also has issues with all the senses in some combo. My biggest worry is her refusing to eat…its awful to watch your child basically starve herself. She’s almost 3 & still can wear a lot of size 18month clothing. She is 33″ tall & only 25lbs ? She won’t even eat most of the food she use to eat. The gastroenterologist is doing all kinds of tests but i think its sensory related! I pray taking the time to write this instead of sleeping I may get some answers….LOL Thank you again…IDK what I’d do without all the wonderful blogs & articles that have helped me so much. If only I could find one to teach me how to get her to eat & how to calm her down. Yea her OT had her in time out with me next to her …my poor baby couldn’t calm down kept wanting me to hold her…to me that’s just terrible!! She said my daughter needs to learn how to self soothe…but how can she calm down when she hasn’t been taught and when she can’t even calm herself down to fall asleep? It just doesn’t make any sense & I trust in these OT that they are trained in SPD so they must know what’s best. SMH

  11. This is really interesting and does explain a little why my dd can sit in a cold bath,but as soon as I pour the water that she has been sitting in over her head for hairwash she screams ” too cold”!

  12. The weird thing is I had this issue when I went through puberty, hormones. So I would get hot easily and whatever was cold to everyone else was just right to me. Then when I had my babies, I went through this again because our hormones get out of whack so we are hot more easily so the whole room is cold while for us it’s just right. So funny how this can overlap.

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