Therapy Tips

An In-Depth Guide: How to Transition Young Children with Autism

Young children with Autism respond well  to structured routines and familiar surroundings. But life has a way of throwing unexpected curve balls, and people need to adapt. Psychologists call this resiliency; the ability to "go with the flow" when things don't go your way. Resiliency is honed in neurotypical children through their development of play and self regulation skills, as well as a sense of humor.

Neurotypical children learn to be resilient when they find ways to self soothe, manage stress, and see the humor in unwanted and/or unanticipated situations. The experiences, paired with the vocabulary associated with that event, are stored in their "memory banks" i.e. episodic memory, for later recall and problem solving as needed. For children with autism more work is needed to make he or she more comfortable with transitions. Here are some important transition teaching tips for for young children with autism.

Target Transition Skills Early

The opposite of resiliency is transitioning difficulty, often seen in young children with Autism beginning their journey of treatment. It is crucial to target transitioning skills right away, by attempting to both understand the cause(s) and plot a course of action. This is a multi-disciplinary issue that needs to be addressed collaboratively, to address the real culprit; disorientation to time.

Neurological Difficulties Similar to Jet Lag

Children with Autism, and special needs for that matter, can have significant neurological difficulty comprehending the concept of time passing. The brain and body may not be in sync, causing hyper-vigilance when living in the moment and fixating on the present, or a disconnected feeling from past/future events. Imagine walking around feeling jet lagged, where your body tells you it's time to eat or sleep, based on your internal body clock, not the the actual time! That's what it can feel like for many of our children. Mix that with possible language delays, unfamiliar routines and/or environments, challenging tasks, and the potential for sensory overload, and you've got a recipe for the tantrum the child with Autism/special needs can exhibit.

How to Counteract Disorientation to Time

To counteract this disorientation to time, and the subsequent transitioning difficulties we all see so frequently, I suggest 3 strategies to try, in this order, and using a team approach where different people are in the "driver's seat" at various intervals:

1. Feed the Need: Implement a sensory diet
2. Mark Time:  Create a physical time duration map to show the passing of time
3. Turn On Helpful Switch: Empower the child and build self esteem

Sensory Diets:

Occupational therapists have long recommended that a child with Autism, who can have sensory processing deficits, be given physical and even tactile breaks at regular intervals, to get “grounded” again when switching activities. A sensory diet can help one connect to the present by engaging in specific motoric behaviors to keep “level” and counteract hyper/hypo-arousal (such as swinging, listening to music), or even strongly chewing something (crunchy carrot sticks, pretzels, or bread crusts etc.) To learn more about sensory processing and the power of a sensory diet, I recommend these sites:

1. Alert Program
2. Sensory Smarts
3. Socially Speaking LLC

Duration Maps:

Understanding the concept of time passing can be one of the most challenging skills for youngsters with Autism to learn and internalize. Disorientation to place and time, sensory processing issues, and reduced delayed gratification skills can all contribute to the child’s difficulty living in the moment, paying attention, and then graciously changing routines “mid-stream”. I have thus found it crucial to provide a concrete road map of sorts, to show the passage of time. I have found it so productive to provide a concrete visual representation of the process involved in a task’s completion, before moving on to the next one. With young children, I have successfully used concrete chains of plastic Lauri™ Math Clips to count down to when a task is done. With older children, I have used the Connect Four™ Game, the iPad Drawing Box Free App (rows of stamps), and even timer iOS Apps (VisTimer Free, Giant Timer, Classroom Timer, Beep Me) which the children can independently program/access as needed. If you are already using a different system to mark time, that’s fine, as long as it’s working! Another tip to try is to visually recreate the environment to reduce the child’s fear of the unknown. Take before/during/after digital and/or video footage of what’s happening in the location child is about to enter. Show it to the child as needed, to build anticipation, increase comprehension, and reduce anxiety. You can use this as a “stand-alone” visual support or string a few together to use in a Social Story; paper or digital. I recommend these sites:

1. Use Visual Strategies
2. Indiana Institute on Disability and Community
3. Help Guide

The Helpful Switch

Over time “in the trenches” I have learned that our wonderful children with Autism are more aware of their strengths and weaknesses than we give them credit for. Many of our children want to connect with family, friends, and educators/caregivers. Many of our children want to be helpful and be part of what’s going on. They may not know how to engage, yet. They may have difficulty initiating and following through, consistently. A vicious cycle can sometimes ensue where the child remembers not being successful or productive, and can be reluctant to try, or to be challenged to try something new. Self confidence is directly tied to episodic memory, to the child’s recall of being successful at something he/she engaged in and completed. So giving opportunities to be helpful, by physically transporting something needed (tissues, water, snacks for later etc.) to the location they are reluctant to enter, makes for a successful social encounter with another person. Having the child hold something to bring to the next activity or location, becomes purposeful scaffolding of self confidence, which goes into the “memory banks” for later recall. Turning on the child’s “helpful switch” fosters empowerment and feeling more in control, instead of feeling powerless in the face of changes in routines. An empowered child is a helpful child, one whose self concept and self esteem can thrive on repeated successful social encounters. Encounters where they did something for someone else, which become the focus of the transition, not the actual transition itself. I recommend these sites:

1. My Aspergers Child  
2. Raising Children 
3. Good Therapy