Sensory play for children with autism, with Joshua Feder, MD

Pediatricians and caregivers can better support children with autism by rethinking sensory play not as a standalone tool, but as a relationship-driven strategy integrated into daily life, according to Joshua Feder, MD, executive director of Positive Development and associate clinical professor in the Department of Psychiatry at UC San Diego School of Medicine.

“Sensory play is not about just getting a bunch of sensory toys, right?” said Feder. “It’s really something that needs to be integrated into the holistic approach to the child.” He explained that understanding a child’s sensory profile—how they process external and internal stimuli—can help caregivers reduce overwhelm and support connection and communication.

Many children, Feder noted, are brought in for evaluation because of issues like irritability or perseveration, which may be misattributed to behavioral problems rather than sensory sensitivities. “What I really get concerned about is when people jump to medication for irritability, when many times those problems that the kids are having, have to do with their sensory experience,” he said. “They may be irritable because of the light in the room or the sound… or they may be inattentive because they’re not responding to their sensory environment.”

He encouraged clinicians to explore sensory factors before prescribing medication, particularly in cases involving irritability or attention issues. Feder added that interoception—awareness of internal sensations—is often overlooked but critical, and that cataloging sensory responses can guide targeted support.

“Once you understand all those different sensory differences, you can start to figure out, 'well, how do I help the child do better?'” he said. “Either pay attention to the things that [the child] otherwise wouldn’t… or help them to learn to tolerate the things that are in their environment that are very difficult.”

For families facing long wait times for evaluations and services, Feder emphasized the value of daily, mindful interaction. “If you can help people to be mindful and curious about the child’s experience… you can think about what might be helpful to the child to expand their world a little bit and their tolerance,” he said.

While professional guidance from trained occupational therapists or developmental specialists is ideal, he added, “you can do that through your own play, your own relationship.”