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Autism and Christmas – Tom’s 21 Tips for an Autism-Friendly Christmas

Christmas can be a magical and exciting time but for many autistic children like my son Tom, the festive period is anything but wonderful.

Tom struggles with changes to his routine, worries about not understanding what is happening and why his usual activities and food are different. When he was younger, if visitors came to the house or we visited family and friends he’d become confused and unsettled as he didn’t know what was expected of him. He was often tearful, frustrated, and distressed.

We tried lots of things and now we know what to do to help Tom and our family have a more enjoyable and relaxing Christmas.  As he turned 21 this year, Tom shares 21 of his favourite tips to help you and your family prepare for an autism-friendly  Christmas. 

#1: Decide what’s the best way to ‘do’ Christmas for YOU and YOUR family.

Making a plan in the following way helped us:

✍🏻Grab a notebook and pen and have a think about the whole upcoming Christmas period.

📝Make a list with four columns headed Achievable, Desirable, High Risk, Impossible

🤔Think about what is planned or expected over Christmas and place each activity under one of the four columns

👏🏻Don’t aim for 💯%- if you can manage most of the achievable, one or two things in the desirable column and come through everything in the risky column you should rightly feel proud.

Don’t give up hope if nothing goes to plan. In our experience, over time many of our risky column activities became achievable.

#2: Make a personalised visual ‘All about Christmas ‘guide.

 Showing all the different things you might do at this time of the year this guide could include Christmas objects, Christmas food and activities that only happen at Christmas e.g., meeting Father Christmas or pulling Christmas crackers

You could make one together like mum and I did with drawings. A photo collage, Christmas scrapbook, or pictures of your family celebrating Christmas also work well.

Like many children with autism, I tend to forget social information, so a permanent visual guide was a great way to remind me what Christmas looks like.   

                                                       

#3: Take time to talk with your child about things that may be worrying them                                                                                  

I was worried about not having my usual breakfast – jammy toast and hot chocolate on Christmas day.

This might seem a little thing to worry about, but it was a huge feeling for me. Mum explained to me that I would have my usual breakfast and that made me feel better.

#4: Make realistic plans for shopping.

Mum tried to avoid taking me shopping during Christmas. The noisy crowds, strong smells, and bright lights in the shops made me feel confused and worried. If she couldn’t find a babysitter, we used to go at quieter times of the day with plenty of snacks to distract me!

Online shopping now makes things much easier

#5: Talk about social rules and different expectations that people might have around Christmastime.

When I was younger, having visitors to my house or going to visit family and friends over Christmas made me feel worried. I didn’t like being out of routine and felt anxious about what I should say and do. Practicing what to say when meeting people and having pictures to remind me what would happen and how I should behave, for example saying hello, please, and thank you really helped.

#6: Talk to your child’s teacher so you know what different things they might be doing and when.

Mum used to have a meeting with my teacher and support assistant to find out what activities were going to be happening and how best to help me.

By letting us know when there would be changes to my routine, for example, doing Christmas crafts instead of my usual lessons or practicing for the carol service I could prepare myself for the changes and didn’t get as anxious. 

Planning for the Christmas party so that I could have my favourite drink and a quiet area to go to when things got too much also made me feel much calmer about going to the party. 

#7: Make a list of special interest gift ideas that you can suggest to relatives and friends when they ask what presents they can buy.

When I was younger, I didn’t get excited about getting toys as presents. But I loved getting things about what I was interested in, for example, lorries and trains. Activities based on my special interests were also good ideas.

Among my favourite Christmas presents were a pillowcase with trains on, a trip to the railway museum and of course getting lots of Eddie Stobart lorries!

#8: Make sure any visual schedules are updated to show any changes to routine or special Christmas events.

Sudden changes to my usual routine like a last-minute practice, craft activity or even something small like moving to a different classroom or popping to see a friend can upset me and cause me to worry. It’s always better to give me as much warning as possible of any changes so I can prepare and cope with them.

It can be exhausting to keep up with all the different things that are happening. A TomTag visual timetable really helps to show me what is happening and when. It’s perfect for use at home and school.

#9: Involve your child in deciding where the decorations should go.

I get worried when there are unexpected changes in things around me. So, if Christmas decorations suddenly appear at home or school, it can shock me. Involving me in deciding where the decorations go and letting me help decorate the Christmas tree can help me feel less overwhelmed.

It’s also important to let me know when the decorations are being taken down too. It’s less stressful for me when there is a warning and a reason given.

#10: Keep sensory armour to hand for trips to the shop, parties, and other festive events where there might be sensory overload.

Loud music, twinkly lights, everything and everyone looking different can be overwhelming for me.

Sensory armour can help and includes:

🎧Headphone to cut out some of the noise and sound. I can also listen to my favourite music to help reassure me when things get tricky

🧢A cap to help shut out some of the flashing lights

🕶Dark glasses to reduce light intensity.

#11: Let your child wear their Christmas costume or party outfit around the house

When possible, buy or make your child’s Christmas costume or party outfit early.

Let them wear it around the house for say, 5-10 minutes over a few days to help them become comfortable with how it feels.

I don’t like the feel of any clothes made out of wool or anything with a label in it as it feels scratchy on my skin.  Fancy dress costumes are also a no-no. I much prefer to wear my own clothes. I don’t mind wearing a Christmas hat– if the label is cut out and I don’t have to wear it for a long time – just long enough for mum to get some photographs is usually ok!

#12: Use an advent calendar or other visual to prepare for and understand the countdown to Christmas.

I used to find traditional advent calendars quite fiddly. When I was younger, we had a large fabric Christmas tree with 24 large, numbered pockets. Each pocket contained chocolate that I could easily reach.

Other ways to make an advent calendar include a Christmas Book Advent Calendar – unwrap a Christmas book each day, little gift boxes filled with knick-knacks, or a treasure hunt with clues.

You can use TomTag to make a fun countdown too!

#13: Prepare your child for how to greet family and friends

Prepare for visitors and visits from family and friends by talking to your child about who they are going to see and how to greet them.

I spent lots of time practicing with mum how to greet people.  Being hugged makes me feel uneasy so I learned how to shake hands with friends and family. I do love being hugged by my sister though!

#14: Discuss the escape plans that it’s ok for your child to use if everything gets too much for them.

It was so important for me to know that if things got too much for me there was a quiet space I could go to ‘escape’ Christmas. When I was younger I agreed with mum that I would show a red card when I needed some time out in the quiet space.

#15: Be prepared that your child might not be able to sit at the table for as long as would like (or maybe not at all).

Be upfront about this with your family and friends if you’re having Christmas dinner at their homes.

I’m happy to sit at the table now for my meal but often need to leave the table when I’ve eaten for a movement break. Knowing that this is OK and that I’m not going to be forced to sit at the table means I don’t get anxious. When I was younger, I had a favourite book or toy to keep me distracted during mealtimes.

#16: For children who won’t eat a traditional Christmas dinner prepare and freeze their meals in advance to reduce the workload on the day.

I used to be a very picky eater. This was because I don’t like changes. I liked things including my food, to be predictable. Having the same foods such as pasta, bread and chips meant I didn’t have to worry about new tastes or feelings in my mouth. I preferred to eat foods that I knew tasted and felt the same.  I also avoided eating meat as this was difficult for me to chew.

My favourite Christmas dinner used to be chicken nuggets and chips – Mum always put some peas on my plate, just in case!

As I’ve got older my fussy eating has changed. I now love a traditional Christmas dinner and my favourite vegetable is broccoli!

#17: Playfully and patiently practice Christmas traditions

These could include receiving and unwrapping presents, pulling crackers, and wearing hats so that your child knows what to expect and can join in.

Here are some things that we did to help me understand what happens at Christmas:

Play wrapping games. Mum wrapped up some of my things – clothes, books, toys and I had to open the paper and find what was inside. We’d play a guessing game by trying to guess what was inside by the feel and shape of the parcel. We used to have something square, round and rectangular so I could also practice my shape names.  Chocolate was always my favourite thing to unwrap!

Pulling crackers. We bought some cheap crackers and practiced pulling them, so I got used to the ‘bang’ sound and it didn’t come as a surprise. I got used to wearing the paper hat from the cracker and looking for the joke inside them.

#18: Think and talk about the sensory overload and extra social demands at Christmas parties.

The school Christmas party used to be very overwhelming for me. Loud music, everybody looking different and the expectation that I should be joining in with dancing and games. 

These things helped the party be less stressful for me:

📝Using a visual schedule showing me what was going to happen

🤗Having a ‘buddy group of friends to help me join in

🕺🏻Practicing dancing at home!

🤫Making sure there was a quiet place for me to go to if things got too much.

 

#19: Some children may be overwhelmed by many presents all in one go. Try introducing gifts one at a time over the day or over several days.

Alternatively, adopt an advent style approach and bring out a small gift each day on the run-up to Christmas day.

On Christmas day, I used to stagger my present opening. I opened some presents in the morning and some in the afternoon. Often, we went on holiday at Christmas time so I would open most of my presents after Christmas once we were back home and in my own time. This worked well for me as I didn’t feel stressed about deciding what to unwrap and doing it all at once.  I could enjoy opening my presents.

#20: Leave some areas of the house undecorated so there’s always a quiet place for your child to retreat to if they need it.

I liked having a Christmas-free zone to escape to when I got fed up with the flashing lights, glittery things, and loud music around the house.  This decoration-free space helped me feel calmer when things got too much.

#21: Many autistic children don’t like surprises so it might help not to wrap presents up.

You could also just tell them what’s inside or use clear cellophane or plain paper for wrapping with a picture attached showing what’s inside.

When I was younger, it didn’t bother me to get a wrapped present, but I didn’t have the ‘surprise feeling’ you usually get before you open it. I didn’t really understand the idea of a surprise, so I had a mixture of wrapped and unwrapped presents.

I used to love anything to do with numbers so receiving a large pack of number cards one Christmas was a lovely surprise!

Tom and I would love to know any tips you have to make Christmas more autism-friendly? 

Clare & Tom x

Useful resources:

  • Christmas & Birthdays Sticker Pack

  • Christmas Survival Guide

  • Christmas Survival Toolkit

  • I Know What To Expect At Christmas & Birthdays Kit

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10 ways to have fun with occupational therapy

  Occupational Therapy Week takes place this  week in the UK .

It has prompted me to reflect on the occupational therapy (OT) my son, Tom  has received over the years. Gulp… it’s also focused my mind on the amount of money I’ve spent on buying OT resources!

The main emphasis for Tom has been Sensory Integration Therapy  to help him cope with his sensory difficulties.  A personalised programme of activities focusing on developing his gross and fine motor skills and his sensory perception (i.e. touch, body awareness, balance, auditory & visual skills) has been game changing. 

Naturally some activities and resources have proved more successful than others so I  thought it would be helpful to select our TOP 10 to share with you.

1. HUG & TUG

hug and tug

Tom followed a series of activities from The Handle Institute . Hug and Tug was one of his favorites and an exercise he still uses today. 

This simple exercise can calm anxiety, increase concentration and help develop fine motor skills.  Just needs two hands and can be done at any time!

Here’s how:

  1.  Rest your arms on a supportive surface or place them lightly against your lower ribcage.  Interlock your index fingers.
  2.   Squeeze and pull with your interlocked index fingers – one relaxes as the other pulls, then the other relaxes and the other finger pulls. Both of your arms remain relaxed – only the fingers are moving.
  3.  Repeat the back and forth pull-release three or four times as the index fingers stay hooked together.
  4.  Unhook your index fingers and interlock your middle fingers , and repeat.
  5.  Continue with all fingers and then, finally, hug and tug your thumbs

 2. SCOOTER BOARD

At his last school  Tom cut quite a dash scooting along the corridor propelled by his arms! Great for building up shoulder stability and core strength.

Sensory Direct have some reasonably priced boards.

3. ANIMAL ACTION CARDS

card exercise 1

Make a set of cards showing different animal walks then take it in turns to choose a card and complete the exercise shown on it. Try dog walks, bunny hops, kangaroo jumps, crab walks – whatever takes your fancy. Great for building upper body strength and a sense of humour!

This is a good activity to do with siblings and as a rainy day or birthday party game.

Stuck for ideas? Pop over to the blog Pinning With Purpose for some good tips on how to make your own animal exercise cards.

4. TIME SHOCK

time shock puzzle

Have you got a steady hand? This frantic beat-the-clock game is great for developing fine motor skills and also uses visual memory.

The aim of the game is to place the shapes in the matching slot before the time runs out. Need nerves of steel though and can get competitive!

5. POP-UP TUNNEL

play tunnel

Crawling helps develop shoulder stability which is important for writing skills. This simple item also offers hours of fun playing peek-a-boo which encourages eye contact.

IKEA, Tesco and the like all have similar versions.

6. PUTTY

Great for developing hand muscle strength. You could even try making your own putty.

Fledglings have are some lovely reasonably-priced Rainbow Putty which comes in a variety of different colours and is colour-coded to indicate the level of resistance.

7. HIDDEN TREASURE

sensory bean box

Fill a tub with rice or another pulse and hide small objects such as toy cars, figurines or sweets. Great to develop fine motor skills and another fun party game.

8. SWING

cuddle swing

Swinging is good for vestibular movement. My son particularly liked this cuddle swing.

They can be expensive to buy so here’s some tips on how to make your own cuddle swing and there’s even some ideas for versions that don’t need attaching to the ceiling.

9. CRAFT ACTIVITY

There are plenty of options here – we chose to make our own domino game using card, craft foam, marker pens and stickers.

There were lots of opportunities to practice fine motor skills with all that cutting, sticking and drawing and we all enjoyed playing the finished result.

10. CHEWY TUBE

chewy aid

Our bright red T-shaped Chewy Tube saved many a shirt cuff and tie being shredded! Very resilient and helps develop chewing skills as well as reducing anxiety. Sensory Direct and  Chewigem both have a good range of oral motor aids to choose from.

Click here to find out more about what occupational therapists do and how occupational therapy can help . 

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Surviving Christmas with help from TomTag

Christmas is a magical and exciting time but for many children with autism and other SEN, the festive period can be anything but wonderful.

Changes in routine, a house pulsating with flashing Christmas lights and a steady stream of visitors can be too overwhelming and lead to sensory overload, anxiety, distress and confusion.
Making adjustments that help your child cope better at this time of the year will hopefully allow them and all the family to have a more enjoyable and relaxing experience.
It’s also a good opportunity to work on important social skills that can be transferred to other situations at different times of the year as well.

my daily routineJust another day

Keeping to the same familiar routines as much as possible, even on Christmas Day, can be key to helping things run more smoothly. There are no rules to say things have to be done a certain way so do whatever suits your family best.

It’s sometimes not possible to avoid some disturbance or change to the regular schedule at this time of year. Children who struggle with changes to routine can find this very unsettling. If they use a visual schedule at home or school, this is a great way to make sure they know about (and can prepare themselves for) anything different that’s going to happen.

If different or unusual foods are likely to be an issue, think about preparing and freezing your child’s favourite meal ahead of the big day so that it’s easy to serve alongside everyone else’s dinner and gives you one thing less to worry about.

decorations and christmas symbolsDecorations

Flashing lights, glittery objects and jingling bells all around the house are natural triggers for sensory overload. Let your child help to choose the decorations you buy and put up and consider decorating gradually over a few days so they are not overwhelmed immediately. Make sure to leave some areas of the house undecorated so there’s always somewhere for the child to retreat if needed.

Be aware of sensory triggers such as balloons, Christmas crackers, party poppers, festive music – consider using headphones or ear defenders at parties, carol concerts or similar events if sudden or loud noises are disturbing.  

Use an “All about Christmas” symbol list or simple social story to support a conversation with your child to familiarise them with all the different things they can expect to find at Christmas time.

Social expectations

family visits tagsChristmas is usually a time of increased social contact and festive events with family and friends. Use a visual schedule to show what’s going to happen before any visitors come to the house or when you’re going to parties, visiting family and friends, church services, etc.

Maybe even keep a separate tag as a checklist to show all the family members they may be meeting and what an appropriate social contact might be for each group (eg. hugs are ok for family, hand shake for friends, etc.).

There’ll be lots of opportunities to teach social skills such as learning to greet visitors appropriately and saying please and thank you. Include relevant symbols in your visit schedule list or use another tag that you keep handy for a discreet reminder of social behaviour rules.

Presents

Many children with autism don’t particularly like surprises and aren’t good at faking delight if they get an unwanted gift. Some may prefer to have their presents left unwrapped or, if they do like the unwrapping part, they might want you to tell them what’s inside first.

They may also be overwhelmed by a large number of presents in one go. Try introducing them one at a time over the day (or several days) or adopt an advent calendar-style approach, bringing out a small gift each day in the run up to Christmas.

Don’t forget to put batteries in toys in advance so that they can be played with straight away!

Relax!

Above all, remember that this is your Christmas as well. Get as much support from family and friends as possible and share out the workload wherever you can. Get children involved by giving them jobs to do which will keep them occupied and give them something to focus on.

We used the kit I know what to expect at Christmas & birthdays for the examples here. We know it can be a particularly taxing and stressful time of year for our loved ones with extra sensory and emotional needs, so there’s also an expanded version of the basic kit available which includes additional tags and blank buttons plus a Feelings & Emotions sticker pack. We call this our Christmas survival kit

This guide is available as a free downloaded using the link below.

  • Christmas & Birthdays Sticker Pack

  • Christmas Survival Guide

  • Christmas Survival Toolkit

  • I Know What To Expect At Christmas & Birthdays Kit

 

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TomTag Feelings tag-o-meter

The TomTag feelings tag-o-meter is a visual feelings thermometer that can be used to support the development of all the skills required for good emotional intelligence.

It can help children to understand and communicate their feelings. By linking with a visual reminder of appropriate actions and strategies, they can learn how to manage those feelings too.

Regular use of this type of visual scale helps children to recognise the causes and triggers for their feelings and emotions. They can work out ways to help themselves improve their responses and handle things better in the future.

Let’s get started

feelings thermometer tag with what's wrong tagAt the start of the school day it’s helpful to know how a child is feeling to assess their readiness for learning today. Use the feelings thermometer as a way for them to quickly and easily communicate this to you. 

You might find it useful to provide a list of further options (like the red tag shown here) to help you identify the cause of any problems. For example, are they sad because they are hungry or tired, too hot or too cold, are the surroundings too noisy or bright?

Once any issues have been dealt with appropriately the child will be more able to access and engage with their learning.

What’s different

Are you expecting a change to routine, an unusual event or a visit to a new place today? Use the same approach to rate how comfortable the child is about this. If they are frightened, worried or anxious you can try explaining more about the reasons for the change or event or what they can expect to happen during the day or the visit.

Encourage the child to think about whether the strength of their feeling is in proportion to the situation. Does their reaction match the level of the problem? If not, discuss strategies they can use to deal with their feelings and talk about what a more appropriate response might be.

Get down to work

Before starting a task or activity, ask the child to rate their anxiety or confidence level about what they have to do. This information can help you to decide what support they might need to be able to complete the task successfully or it can open a discussion about whether their anxiety is proportional and realistic for the task faced. For example, are they:

very anxious and not sure what they need to do or worried that they are not capable of doing it?
reasonably sure of what they need to do but could use a little guidance just to get started?
feeling confident about the task and happy to try doing it alone?

 

How was that?

Revisiting the scale once a task, activity or event has finished offers an opportunity to reflect back and learn from it. Was their actual experience better or worse than they had expected it to be? How would they feel if they were now faced with the same event again?

If they were initially very anxious but with support were able to succeed, should this make them more confident about the next time they face the same task or a new one?

Another good time to check in with the feelings thermometer is after school, particularly as they may keep emotions locked up until they get home. Just as at the start of the school day, it’s a quick and easy way to communicate how they’re feeling and alerts you to any issues that have occurred during the day that might need further investigation or discussion before settling down to homework or evening activities.

What happened there?

strategy tags to manage emotionsSensory overload, changes to routine, difficulties processing information, social interactions or being tired or hungry are all common triggers for anger or challenging behaviour.

Getting a child to think about and try to understand what made them angry or prompted their behaviour begins to develop their emotional self-management skills. Using a feelings diary can be a good way to identify patterns of behaviour and incident triggers and plan for minimising stress at key points.

Encourage the child to use a feelings scale to start recognising how they feel or what their impulses are when their anger level starts to build. Set up some different coloured tags for each level like the ones shown here. Use each list as a reminder of suitable calming ideas they can try to help prevent their progress up the anger/stress scale and bring their feelings under control.

This technique can also be used to identify and respond to inappropriate behaviour from over excitement or a high arousal state.

Just saying

Children not only need to understand and interpret their own feelings, it’s important for them to be able to recognise the feelings of other people around them too.

When a child is familiar with using the feelings tag-o-meter to rate their own feelings and emotions, they can build their skills in appreciating other people’s feelings too.  

As a parent, carer or teacher, you might want to let the child know that you are pleased with their work or attitude today. They may not have behaved well and you want them to understand that makes you sad. Reinforcing your words by showing them on the scale how you feel helps them develop their ability to recognise and interpret verbal and non-verbal emotional signals.

Let’s be friends

school behaviour prompt tagYou can take a similar approach when dealing with social interactions between the child and their classmates, friends and family. If there’s been a disagreement or incident, try using the feelings scale to help those involved communicate with each other about what happened, how they are feeling and how they might be able to better control their actions in the future. Our School Timetable sticker pack (included in the kit “I know what to expect at school”) has a number of useful behaviour-related symbols that would help with identifying positive strategies in these situations.

The more practice a child has at acknowledging and recognising their feelings, using different coping techniques and appropriate communication strategies, the more relaxed and content they can be knowing that they have the skills to cope. A child who can identify his own emotions is more likely to be able to identify the emotions of others. Children who can see a situation from the view point of others are more able to engage in problem-solving and other social activities. 

This guide is available as a free downloaded using the link below. The guide for this topic also covers the information in our post Understanding feelings and emotional intelligence.

  • Back-to-School Self-Talk Prompt Sheet

  • Christmas Survival Toolkit

  • cover image feelings notebook extra stickers

    Extra sticker sheets for Feelings Notebook

  • Feelings & Emotions Sticker Pack

  • Feelings Bundle

  • Feelings Tag-O-Meter

  • I Can Do It Manage My Feelings Kit

  • I Can Do It Share How I Feel Mini Kit

  • I Know What To Expect – My Vaccination Mini Kit

  • cover image product feelings notebook

    My TomTag Feelings Notebook

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Understanding feelings and emotional intelligence

Emotional Intelligence – what is it?

Emotional intelligence is defined as the ability to be aware of and recognise our emotions, understand and express them, and to realise how they affect those around us. Emotional intelligence is known to be a key factor in success in life, quality of relationships and overall happiness.

What type of emotions and feelings do we have? 

Anger

Angry, irritated, mad, furious, upset


We can get angry for lots of different reasons. It can happen when we feel threatened or offended or when we can’t have something that we really want. Our children will often display anger and challenging behaviour when they are finding something difficult, confusing or uncomfortable but are unable to communicate the problem to us in other ways.

Sadness

Sad, unhappy, disappointed, depressed, hurt


Emotions themselves are not ‘good’ or ‘bad’. Everyone will, and should, experience being unhappy, down or disappointed at times. Learning how to recognise and respond to feelings of sadness in a positive way is good for our emotional health.

Fear & anxiety

Anxious, nervous, frightened, scared, tense


Fear can be a useful emotion when it stops us doing things that might be dangerous or bad for us. It works against us when it stops us doing important things that we need to do or when we are unnecessarily worried or fearful about what might happen to us. Being overly anxious affects our ability to focus, learn, and achieve things.

Happiness

Calm, satisfied, happy, relaxed, glad


When a child is happy, calm and relaxed they will be more able and willing to focus, listen, learn and communicate. We can help them by learning what they need and would benefit from in their physical and social environments in order to achieve that status.

Excitement

Excited, antsy, energetic, bouncy, aroused


When children have difficulties communicating, it’s easy to misinterpret their behaviour and wrongly identify the cause. For example,  a child with autism may display repetitive motor behaviour such as flapping or spinning but they may need this sensory stimulation to deal with extremes of excitement and arousal as much as they do when overwhelmed by other emotions.

 

How to use a TomTag feelings tag-o-meter to develop the skills for good emotional intelligence

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TomTag life skill – appointments

Fear of the unexpected, communication difficulties and sensory processing issues are some of the reasons why going to appointments at the doctor, dentist or hairdresser can be challenging and distressing for people with autism.

In this blog, we’ll look at how you can help your child prepare for health-related appointments and develop the skills and strategies to cope with and understand these events to improve their long-term health and well-being.

I know what to expect at appointments can help you prepare for visits to the doctor, dentist, optician, hospital, therapist or hairdresser. Here are some  strategies that can be adapted to take into account your child’s level of understanding and individual needs and will hopefully make these visits more bearable for everyone.

doctor symbolPrepare                                                                        

See if you can arrange some ‘friendly’ visits before the actual appointment so that your child can become familiar with the surroundings – perhaps they can be shown the equipment that is used, sit in the chair, etc. This will help to de-sensitise your child and can flag up issues you may not have considered so that you can address them before going to the real appointment. It will also give you an opportunity to explain to the professional about the particular needs of your child and tell them some of the things they can do to help.

It’s a good idea to try to schedule appointments for when your child is likely to be at their best and when the surgery or salon is quietest – appointments early in the day are often a good choice and you’re less likely to be kept waiting from earlier bookings running over.


comb hair symbolFamiliarise

Try out some role-play at home to start with. See if your child will let you put your hand in their mouth to count their teeth before going to the dentist. Show what happens at the hairdressers by sitting them in front of a mirror with a towel around the neck to comb their hair.

For many children it can be helpful to watch another person having the experience first to get an insight into what to expect. Make a video or take your child along with you when a sibling or friend needs a hair cut or doctor’s check-up. Showing them getting a small treat or reward afterwards is a good incentive too!


hair cut symbolVisualise                                                  

Prepare a visual support (like TomTag) that you can use to explain the order of events and what is likely to happen during the visit. Talk through the events with your child before you go to help reduce their anxiety about what to expect and take the support with you so that you can refer to it again once you’re there.

 


reading story symbolRead it

You might want to try writing a short social story to explain what usually happens on a visit to the hairdressers, dentist, etc. or find basic story books about the subject. We found the Topsy and Tim series particularly popular with Tom!

Check out Living Well With Autism for lots of free downloadable visual support and social story ideas for dentist visits and this lovely story Suzie goes to the hairdresser from Suzie Books.


show and tell symbolCommunication

Talk to the professional you are visiting about the Tell – Show – Do approach,  a technique often used by dentists with young patients to help reduce fear and anxiety about dental examinations.

First they should TELL your child what they are going to do using clear and simple language, supporting verbal language with visual supports if necessary (remember to take TomTag with you!). Next they SHOW the equipment and action involved – a dentist might lightly touch his scraper on the back of the child’s hand to demonstrate the sensation, for example. Now they are ready to DO the action for real.

The Toothpick blog have teamed up with Anna Kennedy to compile a list of autism friendly dental practices in the UK that are recommended by other parents.


well done symbolSensory sensitivities

There will be many potential sensory triggers in these unfamiliar environments that can cause your child anxiety and stress. They’ll be experiencing unusual sounds and smells, there will be strangers in close proximity and the professional will most likely need to touch parts of the child’s body. Bring headphones or music if noises are upsetting and favourite comforting items such as toys, books or computer games. Letting your child know how long the appointment is going to last using some sort of timer might also help.


Ask staff to praise your child immediately and ignore any inappropriate behaviour. Try and stay as calm as possible yourself and use a reassuring, steady voice to help your child relax and get through the experience.

For a more detailed look at strategies, the National Autistic Society have some useful information sheets to help children with autism prepare for trips to the hairdresserdoctor or dentist.

If you’re interested in creating your own TomTag visual supports for appointments  please click on the products listed below.

  • Haircuts & Health Checks Sticker Pack

  • I Know What To Expect – My Vaccination Mini Kit

  • I Know What To Expect At Appointments Kit

  • I Know What To Expect-My COVID Test Mini Kit

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TomTag life skill – shopping

help at the shops tag image 2

Shopping with my son, who has autism, was often the stuff of nightmares! Confused, frustrated and overwhelmed by the bright lights, strong smells and noisy crowds he would scream, run for the exit knocking over displays, leaving a trail of destruction and disapproving glares from other shoppers in his wake. 

Shopping online seemed to be the only solution – why would anyone put their  child (and themselves!)  through this challenge on a regular basis? Put simply, a shopping trip can help develop life skills. The need to plan and organise; the necessity of buying food and the pleasure of choosing what you want to eat; interacting with others – all things I felt were essential and that he deserved for his future.

So, how can you change a shopping trip from a nightmare into a positive, dare I say it, maybe even a fun experience? Here are some of the strategies that we used.

Be prepared

Shopping visual timeline examplesVisual timelines

Create timelines using TomTag to show the different stages of a shopping trip and make sure to talk through them with your child before you go. Knowing what to expect can greatly help to reduce anxiety and stress for a child with autism. The amount of detail needed in your timeline will vary with each child. Use FIRST – THEN prompts in a single tag at the simplest level or link 2 tags together to create a more detailed shopping trip sequence like the ones shown here.

Routine

For my son, the route to the shops was really important to his routine too – try to stick to the same one each time if possible to help prevent distress before you even get to the shops! Include the route or what transport you will use in your timeline as well.

Don’t forget to include a visual prompt to define that there will be a point when the shopping trip will finish too (maybe the home symbol, for example) – cue relief all round!

Make a list

shopping list checklist

Shopping with a list is a good discipline for anyone to adopt. It can save us time and money as we’re more likely to only buy the things we really need.

You can introduce different skills by involving your child in preparing your shopping list. They can learn to budget and prioritise by only including the items that are needed for a meal or recipe. Perhaps they want something that’s not on the list – maybe offer to add it next time if they are good this time to teach delayed gratification.

Taking a prepared list will also help to keep a child engaged whilst shopping as they search for and check things off their list. They’re learning to be responsible and it helps them to realise they can have a role to play in everyday family tasks.

Educate

shopping counting skillsShopping provides a wealth of educational opportunities. Here are just a few examples:

Matching – finding items on the shelf that match the items on their list.

Counting – use a different coloured tag to show how many of each item you need to buy and have them put the right number into the trolley, like this example using apples and oranges.

Calculating – working out the best value choice often involves quite complex calculations, particularly with 3-for-2, half price and BOGOFs (buy one get one free) to compare!

Making healthy choices – reading and understanding food labels is a key starting point to being able to select healthier options.

Sensory considerations

Loud sounds, overwhelming smells and flickering lights can be particularly confusing and frightening for a child with sensory issues. If your child has trouble processing light or noises then provide some sensory armour such as sunglasses, ear defenders or a baseball cap to reduce the potential of sensory overload.

Keep a visual list handy so your child can show you what they are having problems with (too bright, too noisy, thirsty, hungry etc.). Pair it with a list of strategy symbols (deep breath, count to 10, need to leave, etc.) that remind them of suitable self-help solutions.

Behaviour

Allowing for any sensory issues, explain the expectations for behaviour when going shopping and inside shops. Be prepared that your child may not get it right first time, or every time – be patient, practice and remember to praise them when things do go well.

Prepare a visual prompt and talk through the rules before you go. Take the tag with you as a handy reminder should you need it when you’re out and about.

Role play

shoe shop what to expect tagShopping for shoes and clothes with a child with autism can often be particularly difficult and require specific explanation of what to expect before you go.

Try role playing the shopping experience at home first. For example, if you need to shop for shoes you’ll most likely need to get their feet measured as well. Practice having your child let you take off their shoes and touch their feet as the assistant in the shop might do. This will help you know what triggers any specific reaction and then prepare for how to deal with it.

Use a visual timeline to help you talk about what’s going to happen. Take it with you to use as a reminder of the process once you’re there.

John Lewis have recently introduced an autism-friendly shoe fitting service in some of their stores. Do you know of any other local or national shops offering this kind of service to autism families that you’d like to recommend?

Resources

For a more detailed look at strategies to help children with autism cope with shopping trips see this great resource from the National Autistic Society.

If you want to make your own schedules and checklists like the ones  shown in the examples here have a look at the kits and symbol packs listed below.

  • At The Shops Sticker Pack

  • Food & Drink Basics Sticker Pack

  • Food & Drink Extended Sticker Pack

  • Going Shopping

  • I Can Do It Help At The Shops Kit

  • I Can Do It Independent Living Kit

  • I Know What To Expect Going Shopping Kit

  • My Shopping List Sticker Pack

  • Out & About Sticker Pack

  • Shopping For Clothes & Shoes Sticker Pack

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TomTag life skill – coping with Christmas

“It’s the most wonderful time of the year” – but not for everyone.

LIFE SKILL dec coping with christmasChristmas can be a magical and exciting time but for many children with autism the festive period is anything but wonderful. Changes in routine, a house pulsating with flashing Christmas lights and a steady stream of visitors can be overwhelming and lead to sensory overload, anxiety, distress and confusion.

Making adjustments to help your child cope better with this time of the year will hopefully allow all the family to have a more enjoyable experience. It can also provide some valuable learning experiences that help to build those all-important social skills.

We’ve introduced a Christmas and Birthdays sticker pack that contains useful symbols to help you prepare for the festive season and other celebrations. Here are our tips for using these visual supports along with some simple strategies.christmas tag 1

christmas 1Just another day

Keep to the same familiar routines as much as possible, even on Christmas Day. There’s no rules to say things have to be done a certain way – do it the way that suits your family best. If different or unusual foods might be an issue, think about preparing and freezing your child’s favourite meal ahead of time so it’s easy to serve alongside everyone else’s dinner.


christmas 2No surprises

It won’t be possible (or necessarily desirable) to avoid disturbances to routine at home or school altogether. Children who struggle with changes to routine can find this very unsettling but you can use a visual timeline like the example here to prepare them for when something unexpected will be happening.


christmas 3Decorations

Flashing lights, glittery objects and jingling bells can all spark sensory overload. Let your child help to choose the decorations you buy and put up and consider decorating gradually over a few days so they are not overwhelmed immediately. Make sure to leave some areas of the house undecorated so there’s always somewhere for the child to retreat to if necessary.

Use symbols showing items traditionally associated with the event to make an “All about Christmas” list that can help familiarise your child with what to expect.


christmas 4Social expectations

christmas tag 2Christmas is usually a time of increased social contact and events with family and friends. Use TomTag as a scheduler to help your child prepare for visitors to the house or for visits to family and perhaps keep a separate tag as a checklist to show all the family members they may be meeting.

We’ve also included symbols that can be used to reinforce positive social behaviour. Build a tag to use as a reminder for how to greet visitors to the house or to remind them when to say please and thank you.


christmas 5Presents

Many children with autism struggle with surprises and aren’t good at faking delight if they get an unwanted gift. You could leave their presents unwrapped or if they like unwrapping gifts tell them what’s inside first.

They may also be overwhelmed by a large number of presents – try introducing them one at a time or even adopting an advent calendar-style approach, letting them open a small gift each day in the run up to Christmas.

Don’t forget to put batteries in toys in advance so that they can be played with straight away!


christmas 6

Relax!

Above all, try to remember that this is your Christmas as well. If you’re in a good mood and happy, those around you are more likely to be too. Try to share out the workload – try out our Food & Drink stickers and enlist some help with peeling and chopping all that veg!

 

Other resources

The NAS has compiled a list of tips to help you through the festive period.

Do you have any great tips you can share?

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Sensory strategies for personal care

Our lives are full of sensory experiences. We take in information about the world around us through our senses – we touch, move, see, hear, taste and smell.

Many people with autism have difficulties interpreting this sensory information. Sensory sensitivity can significantly impact an individual’s behaviour and ability to develop independence in life skills.

Here are a few of the personal care strategies that have helped me to better manage my son’s sensory-driven behaviours.

DRESSING

  • Use comfortable clothes – consider particularly the type of fabric and length of sleeve
  • Cut off care labels from inside clothes
  • If seams cannot be tolerated try wearing undergarments (eg leggings under trousers) to reduce friction
  • Wash and dry clothes in unscented products
  • Dressing in front of a mirror can help provide visual cues to improve sequencing and body awareness

PERSONAL HYGIENE

  • Use non-perfumed soap
  • Apply firm pressure when shampooing or drying with a towel
  • Be aware of bathroom lighting levels and reduce any loud noises e.g. run the bath before the young person goes into the bathroom
  • Provide deep touch using a towel to head, hands and feet

HAIR CARE

  • Use a firm stroke or pressure as you comb or wash their hair
  • Count or have the young person count as you comb, wash or cut their hair
  • Give a definite time limit to the task e.g. brush or cut until you or they count to 10

 

TOILETING

  • Use moist toilet roll if the young person is sensitive to toilet tissue
  • If feet don’t reach the ground when sitting, using a stepping stool to rest feet on will help the child feel safer
  • Try a padded seat insert if the young person doesn’t like how the toilet seat feels

It’s important to talk to the young person to try and understand their individual issues and to explain each step of what you are doing to help them.

Visual aids can also be used to help the young person understand the activity and remember the order or sequence of actions. Our TomTag self care pack is designed to help guide self care tasks such as dressing, washing, toileting etc.

We also recommend Little Grippers socks which use “stay on technology” to help them to stick rather than grip the skin so they don’t fall down or move around. 

For more tips, this friendshipcircle blog has some really useful information.

Please feel free to share and let us know which strategies have worked well for you.

  • Back-to-School Toolkit

  • I Can Do It Brush My Teeth Mini Kit

  • I Can Do It Learn At Home Kit

  • I Can Do It Self Care Skills Kit

  • I Can Do It Toilet Routine Mini Kit

  • I Know What To Expect – Morning and Evening Mini Kit

  • I Know What To Expect At Home Kit

  • Self Care Sticker Pack