This article was contributed by Leica Anzaldo, Training Manager for the Autism Society of North Carolina.
We have certainly felt the arctic blast this past week, and while it created inconveniences for many of us, for some individuals on the autism spectrum, it wreaked havoc on their lives and those routines on which they are so reliant. Not only has school or work been canceled, but access to the outside limited.
What is at the basis of rigid routines and repetitive behaviors? The answer certainly depends on the individual, but here are some functions you may consider. First, imagine living in a world that is full of inconsistencies, changing rules, and varied expectations. Most of us can adjust to this or have identified our own coping mechanisms that we can access discretely when we need them. Impaired social understanding makes many of these “coping mechanisms” for individuals with autism much more obvious to those around them. I have worked with individuals who work very hard to hold it together all day at school but then must ride a bike up and down the street at least 30 times when they get home to decompress. I have also supported an individual who paces in his backyard so much that there is a deep path in the grass. He uses this routine to escape sensory input and find comfort in a repetitive pattern of behavior that he is in control of. I have also worked with both kids and adults whose only relief from the day’s unknown is to jump while in an outside space. And just this week, I was with a young man who hits golf balls across his yard into a net to calm frustration and prevent aggressive behaviors.
Routines and behaviors can be very important to a person with autism, so attempting to break those routines, change them, or stop behaviors can be very difficult and have negative results. An important strategy is to intervene early. Typically, the longer a person engages in rigid routines and behaviors, the more difficult it will be to change them. Even if your child wants to come home and immediately jump outside on the trampoline for an hour, you can set limits. Use a schedule to show them when they can access the trampoline at different times throughout the day and use a timer to show for how long. This will need to be paired with something reinforcing initially so the person is motivated to engage in this change. For example: “First, Jump for 20 minutes. Then, use iPad for 5 minutes.” This also provides you with a way to expand interests and introduce other activities that may have the same calming effect for the individual.
Prepare for change
If your loved one has a very difficult time with change, such as school being closed, there are things you can do to prepare. Increasing structure can often alleviate anxiety and stress, and even the most verbal individual often can’t rely on verbal feedback alone. Using a visual schedule provides some control of the situation and in turn may reduce anxiety. The schedule itself prepares the individual for the transitions, offers control over the day, provides a predictable and visual representation of what will be happening, and can provide the person with a tool to make choices related to the order of events within their day. Schedules most often do not make the person more rigid, but in fact are a great tool to plug in new activities and transitions that the person might enjoy but wouldn’t have tried if they hadn’t already bought into using a schedule.
A change card is another powerful tool that can be used to prepare the individual for something out of the ordinary. The change card is plugged into the schedule, letting the person know that what usually happens at this time each day is not happening and will be replaced by an alternate activity. For example, if you usually go to the YMCA every day in the afternoon but the roads are impassable due to ice, you can plug in a change card indicating that instead, you will be doing an alternate activity that the person prefers. Or simply add the card or word in that represents the new activity.
An additional important strategy is to practice alternate activities routinely. If your child rides a bike to support self-regulation, what other activities can be done indoors to serve the same purpose? Try these:
- bouncing on a therapy ball while sitting in front of a fan
- walking up and down the steps multiple times while listening to calming music
- pushing something heavy with their legs such as leg pressing another person or doing squats
- using a Wii or other interactive games that involve movement
An important reminder is that you should practice all of these strategies regularly rather than attempting to implement them when the person is already stressed or anxious. Begin using a schedule on a regular basis, starting with just a few activities, and then systematically expanding. For new activities, treat the activity as a new skill to teach. Consider what the environmental stimulus will be that cues the person to access the strategy or understand the expectation and how the behavior will be reinforced. Instruction itself will depend on the skills of your loved one and his or her motivation. Perhaps you begin with a step within the skill that the person can already do, then teach each additional step using a prompt (model, gesture, physical prompt, etc.) that is most effective for the person and reinforce success. Be aware of the person and their stress level throughout; if a skill is too difficult, it is not a good replacement activity.
For now, let’s all hope that the weather turns warmer – and drier – next week!
Leica Anzaldo can be contacted at 704-894-9678, ext. 1603, or lanzaldo@autismsociety-nc.org. ASNC’s Clinical and Training Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and former special education teachers. We provide individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, residential and other community-based contexts. We also deliver workshops to parents and professionals on a wide range of topics including but not limited to, strategies to prevent and respond to challenging behaviors, best practices in early intervention, functional communication training, and enhancing social understanding in individuals with autism.
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