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.
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.
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.
Christmas 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.
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!
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.
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
At 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.
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:
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?
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.
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
You 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.
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?
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.
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.
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.
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.
Occupational Therapy Week took place last week and it prompted me to reflect on the occupational therapy (OT) my son has received over the past few years. Gulp… it’s also focused my mind on the amount of money I’ve spent on buying OT resources!
The main emphasis for my son has been Sensory Integration Therapy to help him cope with his sensory difficulties, with activities focusing on developing gross and fine motor skills and his sensory perception (i.e. touch, body awareness, balance, auditory & visual skills).
Naturally some activities and resources have proved more successful than others so we thought it would be helpful to select our TOP 10 to share with you.
1. HUG & TUG
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!
Visit the Handle Institute page for details of the exercise.
2. SCOOTER BOARD
At his last school my son 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
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
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
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, ELC and the like all have similar versions.
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
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.
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 dominoe 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
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. Fledglings and Rosy & Bo both have a good range of oral motor aids to choose from.
Find out more about what occupational therapsits do and how occupational therapy can hep by visiting the British Association of Occupatinal Therapists website www.cot.co.uk
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.
- 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
- 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
- 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
- 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.
We all experience stress during our daily lives but for many autistic people the experience of stress can feel very intense and cause severe difficulties.
Like many young people with autism, my son has been experiencing anxiety related to an overly-literal understanding of what it means to follow school rules and when he is faced with an unplanned change both inside and outside the school setting. He has a very narrow view of what it means to be in the correct uniform or be on time for lessons or appointments. When he is feeling stressed he will rock on his feet, pace the floor and ask repetitive questions. In these situations, he finds it difficult to respond to any reassurance.
Together with his Speech and Language therapist (‘SLT’) and Occupational therapist (‘OT’) we have been using some strategies to help him. We have taught him that the concept of feeling overwhelmed means either too many feelings all at once or a very strong reaction to a situation. He can now use this word to express how he is feeling. He has been taught a format for identifying the worry and setting out actions to help resolve it. The actions relate to what he can think, say or do to make things better. We’ve taught him the phrase self talk and he is beginning to understand what a trusted adult would do or say to him in that situation to help and to use this as self talk. We are sharing this work with his teachers and support staff to ensure a consistent approach to talking about worries and solutions.
On the suggestion of my son’s OT we are trialling a tactical breathing programme developed for the military and emergency services to use in times of extreme stress. We wanted to have activities that were discreet and applicable to the classroom environment. Tactical breathing is a great strategy as no one needs to know that he’s doing it and he can use it to prepare for stressful situations as well as once he is feeling stressed. We’ve incorporated tactical breathing into an anxiety busting resource for him called the 3 O’s- Overwhelmed, OT, OK.
One of the resources we’re using is a simple free app called ’Tactical Breather’ which I’ve downloaded onto his phone so it’s readily to hand for stressful situations. I’m also encouraging him to use his phone to record worries and solutions so that these can be kept and built up to form a ‘library’ of helpful strategies for managing situations.
It is hoped that over time and with continued support in this area he will become more able to self soothe and manage his anxiety. Incidentally, studies have shown that stress levels of mothers of kids with autism are similar to that of combat soldiers. Perhaps I should download that app for myself too!
This week – 3rd to 9th Nov – the UK’s 30,000 occupational therapists are celebrating Occupational Therapy Week 2013.
Occupational therapy enables people to live more independent and rewarding lives and occupational therapists are the skilled professionals who help people achieve this goal.
Occupational Therapy Week has made me reflect on the huge difference occupational therapy has made to the life of my autistic son Tom over the last 6 years. For Tom, ‘occupation’ refers to daily occupation i.e. the ability to participate in everyday life. Like many children with Autistic Spectrum Disorder (ASD) Tom has a sensory processing disorder which can make everyday tasks overwhelming, such as coping with classroom noise, the feel of certain fabrics or standing in a queue for lunch. He also has difficulties with both gross motor and fine motor activities such as handwriting.
We have worked closely with an occupational therapist (OT) to identify strategies and interventions to help Tom. Activities to improve his motor skills development and reduce his sensory processing disorder have been built into a daily programme and we are very lucky that Tomas is able to follow this programme at school before lessons start. His teachers report that he is able to learn and concentrate better after his occupational therapy sessions. He also follows a ‘Chill Out’ programme devised by his OT to help him overcome any anxiety he faces throughout the school day.
Six years on and I’m very proud of the progress Tom has made and hugely grateful to the occupational therapists who have helped him to carry out activities he needs or wants to do. Now I just need to dig out that ‘Chill Out’ programme for myself!
Find out more about what occupational therapists do and how occupational therapy can help by visiting the British Association of Occupational Therapists’ website www.cot.co.uk.