Helping kids with autism handle activity changes
It is not uncommon for children to struggle with transitions between activities, and those with autism spectrum disorders are even more likely to experience difficulties when prompted to shift gears.
Many individuals with ASD feel most comfortable with predictable and consistent routines, and disruption to this may trigger behavioral resistance and dysregulation.
Whether you are having trouble with transitions between playing with favorite toys and getting ready for bed, or with preparing to leave the house and visit a new place, the following strategies can help your child feel more comfortable and prepared to tackle upcoming changes in routine.
• Provide visual and auditory reminders: Set a predetermined time limit on an activity and share that information with your child. Consider starting a visual countdown timer so your child can see the amount of time remaining for a particular activity. As the transition time approaches, let your child know how many minutes they have left and that it will soon be time to move on to the next activity.
• Write out or draw schedules: Create a visual schedule with images and text so that your child can truly see what is coming next. Talk through the schedule with them and utilize “first-then” language — such as, “First you need to brush your teeth, then you can have time to play with toys.” To support flexibility, make pieces of the visual schedule magnetic or Velcro so that they can be easily rearranged. When possible, provide your child with choices regarding the daily order of activities to instill a sense of autonomy and contribution — such as, “Would you like to go outside before or after lunch today?”
• Prepare for upcoming changes in routine: Despite efforts to maintain structure and consistency, not every day can (or should) unfold the same. What can you do to help your child cope with these inevitable changes? Consider using social stories, pictures, or videos of what might happen during the new activity to help your child process and understand the novel experience. If possible, practice going to the unfamiliar place and easing your child into spending time there — whether it be a new school building, a family member’s home, or an outing to a store or restaurant.
• Build in time for breaks: To avoid feeling rushed and frustrated, consider including buffers in your family’s daily schedule. Breaks between activities can remove potential time pressure or stress from the situation and help to create a calm environment in which your child is more likely to respond in a positive way.
• Incorporate frequent positive feedback: While teaching new skills, it is important to provide ample positive praise to increase the likelihood that your child will continue tolerating transitions and routine changes into the future. Be sure to specifically outline the behaviors that you are praising too — such as “Great job cleaning up your toys right away when the timer went off.” Or “I love how brave you were with visiting somewhere new today. Way to go!”
Change can be hard for us all. By supporting your child to understand and anticipate upcoming transitions, you can help to give them the best opportunity to successfully navigate changes that occur.
• Children's health is a continuing series. This column was provided by Advocate Children’s Hospital. Taylor Dorlack, a board-certified behavior analyst and nationally certified school psychologist, is a pediatric clinical psychologist for Advocate Children’s Hospital.