Routines: autistic children and teenagers
Autistic children and teenagers often like routines and rituals and don’t like change. This means your autistic child might need help to manage changes to daily routines.
Common changes or new situations might include:
- leaving the house
- having visitors at your house
- going somewhere new, like the dentist
- shifting attention between toys, activities or tasks, or moving from preferred to less preferred activities
- doing things in a different order – for example, having a bath at an unusual time
- eating new foods or wearing new clothes
- changing teachers or scheduled activities at school
- not being able to finish activities
- cancelling activities – for example, not going to the park because of bad weather.
Planning for expected changes in autistic children's routines
There are some transitions and changes to daily routines that you can prepare for, because you know about them in advance. They include things like leaving the house, going to a party or going to an appointment.
If your child knows what to expect, they might cope better with these kinds of changes. The strategies below can help.
Social stories are a good way to let your child know what’s going to happen in terms your child can understand.
For example, you can make a social story about going to the doctor. You could use pictures, words or both to describe leaving the house, arriving at the doctor’s, having blood pressure taken and so on. Ending the story on a positive note is a good idea – for example, ‘When the appointment is finished, I get to play at the park’.
By letting your child know what to expect, you cut down on surprises and reassure your child that it’ll be a positive experience.
Timetables are a simple way to let your child know what to expect, and when. You could use pictures, words or both. For example, try using pictures of clocks to explain what time your child can expect a certain activity to happen.
Some children can get very upset if you tell them a birthday party will end at 3 pm and it doesn’t, or if they’re told the doctor’s appointment is at 10 am but they don’t get seen until closer to 11 am. In these situations, it can help to use reference points like morning tea, after lunch or after school rather than specific times. For example, if you want your child to have a bath earlier than normal, your timetable could show a picture of a bath before a picture of your child having dinner.
Older children might like to use timetable or calendar apps for managing events and activities.
Your child might feel less anxious if they can spend extra time making changes. For example, to help your child cope with someone coming to visit you at home, you could spend some time with your child getting ready for the visit. You could talk about what will happen during the visit or look at some pictures of what will happen.
Visits to new places
You might be able to arrange a visit to a new place, like a birthday party venue, ahead of time, perhaps during a quieter time of day. This way your child can get familiar with the environment without being overwhelmed by noise and people. You could also look for images of the place on the internet.
If your child finds it hard to switch from favourite activities, a timer might help. Set the time and let your child know the activity will be over when the timer rings. This strategy could also help with leaving the house. For example, ‘When the timer rings, it’s time to go’. Older children could set their own alarms on their phones or tablets.
It can help to introduce small changes and work your way up over time.
For example, your child might insist on eating breakfast first and then getting dressed, but you want your child to get dressed before breakfast. You could start by just putting your child’s socks on before breakfast. Once your child is comfortable with that, you could try doing socks and pants before breakfast, and so on.
Praise and reward your child when they’re flexible and try to cope with these changes.
Slow and steady
If your child finds it hard to switch between activities, try slowly adding new activities, one at a time.
For example, you might want your child to learn to stop what they’re doing and move to a new activity when you ask. You could start by making the new activity one you know your child will enjoy. When your child has done the activity, praise them and give a reward, like a high five, a sticker or extra time on the computer.
Keep doing this until your child is comfortable moving to the new activity when you ask. Then you could try making the switch more difficult, like moving to an activity your child hasn’t done before.
Keep practising until your child can move to new activities when you ask, even if they’re unfamiliar activities or things your child doesn’t like.
Sometimes it might help to include other people, like your child’s teacher or the doctor, in your plan for change. They might have tips for planning successful transitions.
There are no specific therapies or supports for managing change, but behaviour strategies can help. They include Applied Behaviour Analysis (ABA), Discrete Trial Training (DTT), Positive Behaviour Support (PBS) and Pivotal Response Treatment (PRT).
Managing unexpected changes in autistic children’s routines
Sometimes changes are unexpected and you don’t have time to plan ahead. But you and your child can still prepare for coping with sudden or unexpected changes.
It starts with introducing a warning system for unexpected changes when your child is calm.
Adding a ? to your child’s schedule
One way to do this is to build some ‘space’ for change into your child’s visual supports.
For example, if you use a visual schedule of activities for your child, you can leave gaps between each picture so you can put in other pictures later. You could use a ‘question mark’ to represent a ‘mystery’ or uncertainty. If your child has a written schedule, leave one blank line between each task.
You can use a step-by-step approach to help your child learn how the ‘?’ works. Your child can gradually learn to deal with pleasant change, and then less pleasant change.
- Go on an outing, placing a ‘?’ on the schedule. Make sure something fun for your child happens when it’s time to do the ‘?’ on the schedule. Praise your child for coping. Your child can learn that something unexpected can be a pleasant thing.
- Go on an outing without the ‘?’ on the schedule. At some point slip the ‘?’ into a gap on the schedule. Immediately bring out the fun surprise and praise your child for coping.
- Go on an outing without the ‘?’ on the schedule. At some point make an unplanned diversion – for example, a sibling wants to look at the pet shop, and it’s not on the schedule. Add in the ‘?’, reward your child for coping, and then quickly get back to the schedule.
- Go on an outing without the ‘?’ on the schedule. Make an unplanned diversion that your child usually doesn’t enjoy – for example, visiting one extra shop. Show this by placing the ‘?’ in an appropriate gap in the schedule. When completed, reward your child for coping, and then get back to the schedule.
Once your child is familiar with the ‘?’, you can use it anytime there’s an unexpected change to show there’ll be a diversion from the schedule and then a return.
You could put this technique together with a social story to explain to your child that sometimes things don’t go exactly as it says in the schedule. You could include the things that your child can do when something doesn’t go according to plan. For example, ‘When things change I can take five deep breaths or name all the Pokemon in alphabetical order in my head until I feel calm’.
Another simple way to help older children cope with change is to make a big deal of the concept of ‘flexibility’.
Praise or reward your child whenever they cope with a change or an unexpected event, like not getting a desired table number at a restaurant. Tell your child how wonderful it is that they’re ‘flexible’ and get your child to associate this skill with getting something they like, like attention.