The nose has finally demanded that we pay attention to it and give it its proper due.

If you’re like most people, you haven’t paid too much attention to your sense of smell. Sure, we become more aware of it when a garbage truck passes by, or when we walk into the home of someone cooking an aromatic dish. But otherwise we don’t give it much thought.

Come COVID-19, however, and suddenly smell is a coveted, valued sense for the people who have lost it.

Many people have been asking us how they will once again be able to enjoy a cup of coffee, to experience the scent of good cooking, to discern a spoiled bottle of milk and to catch the cookies before they go up in ashes in the oven. (See addendum to post on regaining sense of smell post-COVID.)

Smell is the major part of what we experience as taste. Smell practically alerts us to spoiled food and other dangerous substances. Smell evokes memories and experiences.

The olfactory organ is not only the center of our faces; it is the center of our physical and emotional lives.

Fast Track to the Brain

When you experience most kinds of sensory input, such as touch or sight or sound, the stimulus is sent to your brain through several neuronal pathways. On the way, the transmission goes through hundreds of synapses (gaps between nerve cells). Eventually the stimuli reaches your cerebral cortex which analyzes it and instructs the body how to react. 

Your sense of smell skips all of these steps. There are two and only two synapses between your nose and your brain. Additionally, smell doesn’t wait for interpretation by the cerebral cortex. Smell is intercepted first by the prefrontal cortex, which is the part of the brain involved in modulating emotions. 

Your brain’s initial response to any smell is instantaneous and unconscious. Smells can evoke emotions and physical/physiological responses without any “permission” from your intelligence. Your sense of smell can trigger all sorts of behaviors, negative and positive, as well as emotions and memories.

Smells trigger your memories and emotions:

  • This dress’s smell reminds me of Grandma cooking in her kitchen.
  • It smells just like the cigarette the superintendent smoked in the apartment building I lived in when I was a kid.
  • This perfume makes me think of Mom.

Smells trigger you physiologically:

  • The milk is spoiled; you get queasy.
  • You pass the bakery and salivate.
  • You use aromatic soaps in the bath and feel relaxed.

Smells trigger your behaviors:

  • Pleasant-smelling stores will make you buy more.
  • Certain smells utilized by casinos induce gambling and/or addictive behaviors.
  • Various smells can trigger impulsive and wild behavior.

What? Impulsive and wild behavior? 

Yes, your child’s impulsive behavior may be stemming from smells that are triggering him. We are extremely passionate about this subject, especially since it’s not well-known to most people. We believe that much negativity can be avoided with greater awareness of this connection. 

A Rose By Any Other Name Would Still Smell

Just like some children are hypersensitive to touch, others are hypersensitive to smell. Just like a child may act out when wearing an itchy sweater, a child can act out when smelling something that’s offensive to him.

Say you’re going shopping with your hypersensitive son Noah. He’s excited to spend time with you and is on his best behavior. You enter a HomeGoods store. He starts acting up. He becomes anxious and upset. 

“Noah, stop whining right this minute.”

“Noah, stand right over here and stop running around. You’re bound to knock something over.”

“If you don’t stop screaming right now, I’m not going to buy you the flashlight I’d said I’d get for you.”

It’s too easy to fall into the pattern of punishing Noah for his impulsive behavior, while, in reality, the issue isn’t behavioral at all. His reaction is completely reflexive with zero cognition. Poor Noah!

We often think of HomeGoods stores as a minefield for hypersensitive kids. There’s the potpourri, the soaps, the candles and all things smelly. A child’s hypersensitive olfactory cells are being assaulted by smells that are triggering him. He feels as off-balance as he would if someone was constantly poking a finger into his back. 

If you’ve ever experienced first-trimester hypersensitivity to smells, you can understand what your hypersensitive child is going through every day. A pregnant woman might logically know that chicken soup smells good, but this knowledge will do nothing to quell the nausea. If your spouse were to say, “It smells fine to me! Just pull yourself together and stop making such a big deal about it!” the likely consequence is that he will soon be wearing your chicken soup.

Let’s not even think about the raw ingredients for chicken soup.

So too with hypersensitive children. Smells take a fast track to the subconscious brain, bypassing every shred of logic the child has, and result in impulsive, knee-jerk reactions and behaviors. The child is not in control. 

We see kids who suffer from this all day long. They can’t stand the smell of someone’s lunch. They can’t handle their teacher’s perfume. They’re in the classroom all day with nowhere to escape. Consequently, they can’t focus during class because the smell is looping through their minds constantly, preventing concentration and prompting poor behavior. Understand that if smells are triggering your child, his impulsive behaviors are literally involuntary, and not his fault.

Lack of awareness of the contribution of the olfactory sense to behavioral issues can lead to inaccurate diagnosis and, consequently, medication.

Trigger Warning: Tuna and Eggs

Michael is a cooperative and well-behaved little boy all morning at school. Every afternoon, he acts up in his English class. He is disruptive and rowdy. His teachers are confused. How is it that he behaves well in the morning but loses his patience every single afternoon, after lunch hour? 

The possibility of hypersensitivity to smells arises. The smells in the school lunchroom (think ketchup, tuna, eggs) may have triggered Michael.

An OT evaluates Michael. After ruling out different potential issues, the OT has him eat his lunch (brought from home) in his classroom instead of the lunchroom. Consequently, Michael is calm and well-behaved in the afternoon.

Yes, he was being triggered by the smells in the lunchroom. Being empowered by this knowledge is a huge first step. Now what? Should he avoid the lunchroom for the rest of his life? 

When we work in specialized settings or with very young kids, we can divide the class based on their food choices for the day. The kids having tuna sit with tuna, eggs with eggs, and grilled cheese with grilled cheese. No one smells anyone else’s potentially-triggering food and all is good. 

Of course, this is not practical for older kids in a regular school setting. Therefore, under the guidance of a qualified OT, kids like Michael can be desensitized to lower their reactivity to smells. By a guided regimen of exposure to various specific essential oils, Michael’s hypersensitivity can be regulated. 

Knowing the Nose

How do we know if behavioral issues stem from an olfactory hypersensitivity? And how do we deal with it? Let’s take a closer look at the process:

Step #1: Discovery and Awareness

The first step is to identify the issue. How do we source a child’s impulsivity to a hypersensitive sense of smell? Investigation can include asking your child how they feel about specific smells you have isolated. 

In our OT practice, we would do a thorough intake in which we analyze if the child has gone through any environmental shift recently, along with the occasions on which the child becomes hyperactive, so we can inspect potential exposure to new smells. 

It’s also important to keep in mind that children with underlying disorders such as SPD or anxiety-linked behavior (such as OCD) may have co-existing olfactory issues that may warrant further evaluation and treatment.

Step #2: Desensitization 

In cases in which the child is identified as hypersensitive, we do a desensitization protocol using essential oils. 

We figure out the exact oils needed for the particular child based on the child’s profile. We employ methods such as dabbing a drop of oil on the child’s collar every day and slowly adding more every day. With time, the child adjusts to new smells and her ability to handle the smells.

Note: Do not experiment with essential oils on your own. For children with a chemical imbalance such as ADD, anxiety or sensory processing disorder, the wrong smells can trigger them terribly. (Additionally, lavender oil is unsafe for boys over the age of nine. It can hinder development in certain areas.) You must consult with a professional before using any essential oils.

If your child has aversions to certain smells, and it affects their eating, but it isn’t serious enough to warrant professional intervention, here’s what you can do:

Identify

Help your child identify which smells bother them. You can do this by keeping a food journal to target the smells that are setting them off.

Communicate

How do these smells make him feel? 

Validate

It’s okay not to like certain smells. 

It’s also okay for the child to cover his nose, but teach your child how to handle social settings where covering one’s nose would be inappropriate. The main thing is not to downplay or to make a big deal about it. (“Don’t be ridiculous, this is perfectly good chicken salad!”)

It’s also all right to accommodate the child by placing the serving dish containing the offensive food far from the child at the table, or to place a lid on the dish.

Desensitize

Slowly expose your child to the smell or taste they dislike.

  • Let’s say Ashley can’t handle the smell of egg yolks and you’re constantly separating the whites for her omelet. Start by adding a drop of a yolk to her white every day. Up the amount of yolk until Ashley is comfortable smelling and eating egg yolks in her omelet. Try this with any food your child has an aversion to.
  • If your child does not like fish, start desensitizing by using the least “fishy” of fish. 
  • Some foods’ smells are altered as they’re cooked, like onions. Some children cannot process this change of smell. Invite your child into the kitchen to help you prepare foods using the foods they dislike to help them process the change of smell.

Again, it’s important to note that these home tips are not how we treat hypersensitivity to smells. OTs look at the bigger picture, rather than focusing on individual smells.

Wait Patiently

The good news about smell hypersensitivity is that our olfactory cells are the only neurons in our body that don’t regenerate once they’ve reached maximum capacity. This means that as children hit their teens, their sense of smell diminishes slightly.

Your 18-year-old son suddenly asking for sushi? Your 12-year-old willing to try tuna? Yes, your child’s sense of smell (and hence their sense of taste) has weakened and become more sophisticated. Most cases of smell hypersensitivity resolve with time.

The Experience of Smell

Our sense of smell provides us with an additional way to experience the pleasant aspects of this world, and alerts us to noxious smells for our safety. But our sense of smell is so much more than that. It impacts us emotionally, physiologically and physically. It adds layers of interpretation and recall for our emotions and memories. Smells translate into our ability to focus and live in the moment. 

Who would have guessed what the humble nose knows? 

**

Addendum #1: Babies and Scented Products

We are big proponents of using scent-free products for babies. Good-smelling lotions, shampoos and baby perfumes are all there for the mommy’s pleasure, but not the baby’s. A baby is very sensitive to smell, and it’s a shame to expose kids to these smells early on. 

As an aside, exposing babies (that are predisposed to various issues) under thirty months old to peppermint oil can potentially cause seizures. 

In general, when using oils with children, always consult with a professional. Many essential oils should not be used on children until they are of a certain age. Based on a child’s age, a professional will recommend how to dilute an oil if used directly on the skin, as well as the appropriate dosage. Many are used to treat a variety of physiological symptoms, however, depending on one’s olfactory sensitivities, their use may cause more harm than therapeutic benefits if not handled with care. 

Addendum #2: Loss of Smell After COVID-19: The Good, the Bad and the Opportunity

First, it’s important to note that the coronavirus hasn’t affected anyone’s actual olfactory neurons, only how the smells actually get transmitted to the brain. That’s really good news, considering that olfactory cells are unable to regenerate.

The inflammatory effect of COVID-19 on the olfactory system may cause swelling of the tissue and mucosa in the nose resulting in loss of smell. As the swelling slowly begins to recede and the olfactory pathway is able to be interpreted, most individuals’ sense of smell will slowly return, with the time varying between individuals.

Clinical trials are being implemented to study the effects of olfactory training using essential oils such as rose, lemon, cloves, and eucalyptus, with each of these particular essential oils targeting a particular category of scents (i.e. floral, citrus). Protocols being utilized have specific frequencies and time periods for their efficacy. We recommend doing due diligence and consulting with a professional before implementing any protocols.

If your children have lost their sense of smell due to COVID-19, take advantage of the unique opportunity to work on various issues. For starters, it’s a great time for your picky eaters to try new foods. If the smells of the foods were bothering them previously, you can work on getting them used to foods’ textures only.

Additionally, it’s a good time for speech therapists and feeding therapists to determine if a feeding issue is behavioral or sensory. Normally it is hard to isolate the factors that could contribute to pocketing food, tactile defensiveness or exhibition of texture issues. Now that smells are momentarily out of the way, take advantage of this window of opportunity.

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