By Jill McGrale Maher
The holidays are upon us, with family members, friends, and neighbors from far and wide gathering in celebration to share a meal, exchange gifts, and enjoy being together. But for children with Autism Spectrum Disorder (ASD), holidays can truly be overwhelming, as they are often accompanied by sensory overload, and the routine in which they find comfort is altered.
There are many different strategies that can help children and families with ASD navigate what can be a stimulus-filled time of year:
1. Keep the schedule consistent. Many families like to do things "on the fly." This is simply not going to work, as children with ASD often do not do well with change. They need consistent structure similar to what they are accustomed to at school or through behavioral center or home-based services.
2. Set up a visual activity schedule. Picture cards representing daily events work well, as well as written lists for children who can read. Parents may put them in a list or on a calendar. Others need something a little more involved, in which the event is added to the calendar and reviewed every day leading up to the event. For example, if grandparents are arriving for a visit on Dec. 17, post pictures of them on Dec. 17 on the calendar, along with a list of all your family's planned activities. This gives a visual representation of what will occur when the grandparents visit. Additionally, review the calendar and corresponding pictures daily.
3. Make use of "surprise" icons. Teach your child to prepare for a surprise by using special icons, such as a question mark, on the calendar. Essentially, your child will gain the understanding that a new event -- a surprise -- will happen when the "surprise" icon appears. By using this type of visual schedule and cue, holiday activities that may not yet be named, and which are not typically part of his/her day, become part of the planned routine. The "surprise" icon can also be used when a very unexpected event occurs.
4. Practice going to a place beforehand to reduce anxiety. Say, for example, the entire family is looking forward to attending a holiday concert where your niece will perform a piano solo. First, be sure to add this event to your child's visual activity schedule. Next, if possible, visit the venue so your child is familiar with almost every aspect of the event -- from the roads you will travel to get there to the auditorium itself.
5. Role play and rehearse. Whether the grandparents are coming for dinner or you're attending that concert, do some role-playing and go through the motions of being there ahead of time. Practice what to say to the grandparents, and when to sit quietly and when to clap during the concert. It may also help to make a video and narrative of the process and watch it with your child prior to the event. Someone once said to me, "No one is going to know how many times you've practiced being there." It's true. The more your child and family practice being there, the smoother the event will go, the more comfortable your child will be, and the more socially skilled your child will appear.
6. Create a social story. A social story tells your child what will happen, in detail, at an event -- who will be there, what to eat, what to do, and what happens after. You can follow up this social story with a contingency that says if they follow through, there is a reward afterwards, such as playing video games when the event is over.
7. Allow extra time. Rushing is never good. A misplaced shoe or car key can throw off even the most carefully made plans. Note the amount of time it takes to get to/from a place when you practice going, and factor in plenty of extra time.
8. Bring along activities. Be sure to bring along a bin of activities so your child always has something to do in the car, at someone's house, and so forth.
9. Avoid holiday shopping with your child. It rarely proves successful, whether you've carefully planned a shopping expedition or you want to make a "quick stop" at the department store for a last-minute gift on your way home. It's best to do your shopping when your child is otherwise occupied.
10. Keep holiday activities a suitable length. Estimate how long your child can be appropriate and not anxious, and plan for an amount of time that is less than that. Don't plan for your child to do things that he/she doesn't do at any other time of the year, for example, sitting at a table for a meal. Make sure that what you are expecting at the holiday usually happens at home on a regular basis. Don't be afraid to make exceptions, such as allowing your child to use an iPad at the table so you can sit and enjoy your meal with adult company while your child is occupied.
What if you've anticipated all potential stressors, taken some (or all) of these steps, and things still go awry? Don't be discouraged. It's counterintuitive to never try again if one event goes wrong. Keep trying. Above all, keep things as predictable as possible, as this will set your child up for success.
Jill McGrale Maher, M.A., BCBA, LABA, is director of Behavioral Concepts, Inc.'s Fitchburg location. BCI has two locations, Worcester and Fitchburg, and serves children with autism from communities within a one-hour radius of its Worcester location. For more information, visit bciaba.com.