ALPIMS • Sensory & Neurodevelopmental
What feels closest right now?
Too much input, not enough input—or something hard to process?
Choose one description for a small starting point. Your needs may change with the setting and the day.
You can ask for an adjustment without explaining everything.
You may need less of one sensation and more of another. Choose what feels comfortable rather than following a fixed list of “calming” activities.
Sudden hearing loss needs urgent medical assessment. Sudden vision loss, severe eye pain, or new flashes with a sudden increase in floaters or a curtain-like shadow needs urgent eye assessment.
Do not assume these changes are sensory overload or visual snow. For severe breathing difficulty, collapse or new stroke-like symptoms, call 000 in Australia.
A small check-in
Open whichever fits. You do not need to read every section.
Everything feels like too much Overwhelmed • hard to think • needing fewer demands
Reduce one source of input: pause a conversation, lower a sound or move somewhere quieter if possible.
You might say: “Less input and fewer questions, please.”
Support during overload
Delay non-essential decisions and allow recovery time. An explanation can wait.
If speaking is difficult, try a written message, gesture or pre-agreed signal.
Supporters can reduce talking, offer one simple choice and ask before touching. Offer space while keeping help available.
Sound is too loud, uncomfortable or painful Hyperacusis • sudden noise • difficulty with competing voices
Lower one sound, move farther away or request a quieter place.
For conversation, try one speaker at a time or written information.
Assessment and sound support
Hyperacusis involves reduced tolerance to sound. Ordinary sounds may feel excessively loud or sometimes painful.
Difficulty following speech in background noise may also need assessment. An audiologist or clinician can help with persistent difficulties, pain or hearing changes.
Use hearing protection for hazardous noise. For everyday sound intolerance, seek individual advice about earplugs, headphones and sound therapy. Do not force yourself through painful exposure.
Particular sounds trigger a strong reaction Misophonia • chewing • sniffing • tapping • repetitive sounds
Create some distance from the sound, change seats or take an agreed break.
You might say: “This sound is triggering a strong reaction. I need a short break.”
Understanding misophonia
Misophonia involves strong reactions to particular sounds. These may include distress, disgust, anger, tension or an urgent need to escape.
The sound does not have to be loud. Misophonia differs from hyperacusis, although both can occur together.
A strong reaction does not mean you are choosing to be difficult, or that the person making the sound intends to upset you.
Support without blame
Agree on seating choices, a break signal or a different arrangement for eating, working or travelling.
Optional background sound helps some people but adds to overload for others. Choose what works for you.
Do not deliberately provoke a reaction to test tolerance. Any treatment involving triggers should be collaborative and individually planned.
Some people benefit from adapted psychological therapy. This does not establish that misophonia is caused by anxiety or trauma.
Step away before conflict escalates. Understanding the reaction can support prevention, while hurtful behaviour still needs repair.
Light, screens or visual clutter are difficult Glare • busy spaces • eye strain • visual discomfort
Reduce glare, adjust screen brightness or pause a visually demanding task.
Choose a simpler view or comfortably lit space.
What might need assessment?
Light sensitivity can occur with migraine and other conditions as well as sensory differences. New or changing symptoms need assessment.
Request larger text, less animation or information in smaller sections where helpful.
Persistent visual disturbances deserve their own assessment rather than being assumed to be overload.
I see persistent visual static or other disturbances Visual snow • flickering dots • afterimages • light sensitivity
For familiar, assessed symptoms, reduce glare and simplify the visual task if helpful.
If symptoms are new or changing, arrange assessment rather than assuming visual snow.
What is visual snow syndrome?
Visual snow describes persistent tiny flickering dots, often compared with television static, across the visual field.
Visual snow syndrome includes this experience alongside additional symptoms, which can include prolonged afterimages, light sensitivity or difficulty seeing at night.
It is distinct from a typical temporary migraine aura, although migraine can coexist. It should not automatically be explained as anxiety or ordinary sensory overload.
Eye examination and, where appropriate, neurological assessment help consider other causes. Seeing static alone does not confirm the syndrome.
Comfort, participation and care
Try comfortable lighting, larger text, less screen clutter or shorter reading periods. Adjust one thing at a time.
Treatment evidence is limited and responses vary. Discuss proposed medicines, lenses or visual exercises with an appropriate clinician.
Explain the effect on reading, work, sleep or safe travel. Practical support can address these difficulties even when visual symptoms persist.
Sudden vision loss, a curtain-like shadow, new flashes with a sudden increase in floaters, or severe eye pain needs urgent eye assessment.
Touch, clothing or temperature feels uncomfortable Labels • seams • unexpected touch • heat or cold
Change one uncomfortable item or adjust the temperature. Choose a texture you already tolerate.
You can ask others to check before touching you.
Comfort is individual
Some people enjoy pressure; others find it painful or restrictive. Do not assume pressure or a weighted blanket will help.
Any support should be optional and easy to stop. Seek advice before using weighted equipment, particularly with breathing or mobility concerns.
New burning, numbness, skin changes or pain may need medical assessment alongside sensory support.
Smells, tastes or food textures are difficult Fragrance • cooking smells • strong flavours • textures
Reduce an unwanted smell if possible, or choose a familiar food with a tolerable texture.
Keep nourishment manageable rather than forcing a difficult food during overload.
Sensory needs and physical reactions
Sensory aversion, irritation, food intolerance and allergy are different experiences. An unpleasant smell does not establish an immune reaction.
If eating becomes very restricted, seek support from a dietitian or clinician who understands sensory needs.
Wheeze, swelling or other physical reactions may need their own assessment and action plan. Severe breathing difficulty is an emergency.
I need more movement or sensory input Restless • seeking rhythm • needing to move or fidget
Choose a familiar, safe option: a fidget, gentle rocking or a comfortable change of position.
Stay within your physical limits.
Support harmless movement
Repetitive movement or stimming can express enjoyment or help manage sensory experiences. Harmless movement does not need to be stopped simply because it looks different.
If a movement causes injury, seek help finding a safer option that meets the same need.
Adapt movement for pain, joint instability, dizziness or post-exertional malaise. Vigorous activity is not always appropriate.
I am unsure what my body needs Hunger • thirst • temperature • toilet needs • tiredness
Is it time for food, a drink, the toilet, a temperature adjustment or rest?
You do not need to scan every body sensation.
External cues can help
Awareness of internal body signals is called interoception. Signals may be difficult to notice or interpret, or may feel unusually intense.
A familiar routine, gentle reminder or accessible supplies may be easier than relying on a clear internal feeling.
New or unexplained bodily symptoms still deserve medical attention.
I am not sure—or several things fit You can start with one adjustment
Ask: “What would I like less of—or more of—right now?”
Change one thing. Stop if it makes you less comfortable.
Finding a useful pattern
A short note may help: “This setting was difficult; this adjustment helped.” A detailed diary is optional.
An occupational therapist with relevant experience may help assess needs and adapt daily life. Hearing, visual or painful symptoms may also need assessment by other professionals.
What does the Sensory domain include? Sensory experiences, processing and support needs
This domain considers how sound, light, touch, smell, taste, movement and internal body signals affect daily life.
Sensory differences can involve increased sensitivity, reduced sensitivity or a mixture. Needs may change across situations and over time.
Misophonia, hyperacusis and visual snow syndrome are distinct experiences or conditions that may also be relevant here. Grouping them in this domain does not mean they share one cause or treatment.
Sensory support and medical assessment can both matter.
Sensory symptoms alone do not diagnose autism or ADHD. Migraine, hearing or eye conditions, skin problems and other concerns may need their own assessment.
Could one support help across several domains? Less overload • easier communication • more participation
A quieter space may make communication easier. Comfortable lighting may help during a light-sensitive headache. Comfortable clothing may remove one source of strain from the day.
Predictable adjustments can reduce uncertainty about whether an activity will be manageable.
Choose supports for their benefit. One helpful adjustment does not prove that every symptom has the same cause.
Explore supports across domains →What is one next step?
Keep a helpful adjustment, explain one preference or ask for support with a recurring difficulty.
The goal is comfort and meaningful participation, with room for your choices and physical limits.
Resources & further reading
- National Autistic Society: Sensory processing and support
- NHS: Hyperacusis
- Oxford Health NHS: Misophonia
- NHS: Hearing loss and urgent symptoms
- Visual Snow Initiative: Patient resources
- Visual snow syndrome: Clinical study of 1,100 cases
- healthdirect: Migraine
- ALPIMS: Finding supports that fit
Start with one relevant resource. You do not need to work through every link.
ALPIMS is an organising framework, not a medical diagnosis. This check-in provides general information and optional support ideas. It is not a diagnostic tool or an individual sensory treatment plan. Seek assessment for new, persistent, painful or changing symptoms. Support should respect consent, communication preferences and other health needs.