For my son, Tom, thinking about our family Christmas meal is causing him anxiety. Spending time together and creating memories over a shared meal – it’s what many people love about Christmas – but it’s not so easy for an anxious teen with autism. Continue reading Coping with a family Christmas for an anxious teen with autism
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.
Many shopping experiences can be extremely difficult to cope with for autistic individuals and those who care for them. Changes to routine, difficult social interactions with strangers and overwhelming sensory experiences are just some of the issues that can cause stress, anxiety, fear and meltdowns.
So why do we bother?
We all need food to eat and clothes to wear so going shopping is a necessary and important part of our lives. Online shopping can offer us a great alternative to physically leaving the house and going to the shops but it isn’t always the best way to get what we need or the ideal long term solution.
Shopping can help us develop good life skills. We need to plan and organise to make shopping lists or know which shops to visit. We need to understand money and budgets. Having strategies to cope with social experiences and sensory problems can increase our independence, reduce isolation and help us to be part of a community.
Start planning early
Use a visual routine chart to introduce the idea of your shopping trip. Go at a quieter time of day or week if possible and give as much warning of the upcoming trip as you can. Sneaking in a last minute or surprise visit is best avoided.
You can use your visual chart to show how you will get there (e.g. car then walk), what sort of shop you are going to and what you need to buy. If you regularly use the same route or transport, try to stick to it or make sure you explain the change of route with visual prompts.
What’s going to happen?
Set up another visual list with more detail about what to expect in the kind of shop you are visiting. For example, at the supermarket you need to put things in a trolley or basket, walk together, queue at the checkout, put the shopping in a bag, then pay.
This preparation is particularly useful when shopping for clothes and shoes which can both be especially challenging shopping experiences. Preparing a simple social story and using a visual timeline will help you to talk about why we need to do this kind of shopping, what’s going to happen when you get there and what it might feel like.
Ask and answer questions
Why do we take our clothes and shoes off here but not in other shops or public places? Why does the shop assistant get close and possibly touch us when they need to find out what size we need?
Use the time before you go to ask and answer these sort of questions and think about the strategies you and your child can use to help them stay calm. You could even try some role-playing at home too.
Remember to take your TomTag visual prompt to the shops with you and use it as a reminder of the process once you’re there.
Bright white lights, rows of brightly coloured objects, background music, strong smells and noisy crowds make supermarkets and shopping centres some of the most likely places to trigger sensory overload, leading to meltdowns and consequent behaviour issues.
Try using ear plugs or defenders to dampen noise and dark glasses or peaked caps to reduce the light intensity. Avoid strong smelling areas of shops such as washing powder aisles or perfume sections.
Keep a visual list handy so your child can show you what they are having problems with (too bright, too noisy, too smelly, thirsty, hungry, etc.) and pair it with a list of strategy symbols (deep breathe, count to 10, need to leave, etc.) that you can use to remind them of suitable self-help solutions.
Keep them busy
Giving your child the responsibility for finding items on your shopping list is a great way to avoid boredom and focus their energy. You can also make up games to keep them interested; for example, be the first to find 3 items on your list and turn the symbol over when you find them.
Involving children in helping to prepare the shopping list at home before you go can also be a useful way to encourage engagement and interest.
You might want to take a favourite toy or fidget or let them use a computer tablet or phone as a distraction as well.
Make your own planners and checklists
We used the kit I know what to expect going shopping with the optional symbol packs My shopping list and Shopping for clothes & shoes but TomTag is a versatile system with the flexibility to choose from a range of toolkits or put together your own combination of components and symbol sets. Links to all products below.
This guide is also available as a free download using the link below.
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.
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.
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!
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.
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!
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.
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.
If you’re interested in creating your own TomTag visual supports for appointments please click on the products listed below.
Shopping can be an exhausting experience even without children in tow but we all know that there are times when shopping without them can’t be avoided. There will even be times when we might want to take the kids along to help them learn some important new skills.
A shopping trip can help develop life skills on a number of levels. In the early years, understanding behavioural expectations or learning to deal with different sensory stimuli might be the primary aim. An older child or teenager preparing for independent living might be learning to choose the items they need in a supermarket and how to pay for them.
With our TomTag Tips and the right planning and preparation, there’s no reason why you can’t turn your shopping trip into a productive, educational and dare we say it, maybe even a fun experience!
Can be used effectively to help children with autism understand why we need to go shopping and what to expect when they get there. Try a Pinterest search to find examples for writing your own shopping social story.
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.
For some children, the route to the shops might be important to their routine too – try to stick to the same one each time if possible to help prevent them becoming distressed 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 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.
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.
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.
Have a signal your child can use to indicate when they are feeling overwhelmed. My son would show us his red TomTag when he’d had enough!
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 then take the tag with you as a handy reminder should you need it when you’re out and about.
Shopping 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.
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?
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.
Sleepovers – or more accurately ‘stay up late, midnight feast, pillow fights and no-sleep’-overs! First sleepovers are a big step for most kids anyway and can be a particularly daunting prospect and social minefield for children with autism (and their parents!).
Of course, you are the best person to gauge when your child might be ready for their first sleepover or night away and there’s usually no reason to rush this. There may be unavoidable times though when your child needs to stay away from home for other reasons – parental separation, overnight respite or a hospital stay, for example. If skills have already been practiced or preparations made, dealing with an emergency visit could be a lot less stressful for everyone involved.
Careful planning and thorough preparation is the key to ensuring your child’s overnight stay has more chance of being a successful and happy experience. Using your TomTag button holders and our In the house and Staying away from home symbols, you can create handy visual supports that will help prepare your child and ease any anxieties about their next stay away from home, wherever that may be.
Here are our top tips for sleepover success but we’d love to hear your stories and advice too!
Plan, plan and plan again
Try role playing events such as getting up in the night for the toilet or asking for a drink. Social stories are a great resource that help explain what your child can expect in common social situations. Read A Parents Guide to Social Stories from the ‘Normal Enough’ blog for a great explanation about creating your own, including a brilliant example of a sleepover story.
** UPDATE ** Normal Enough blog link broken – try these ideas from Child-Autism-Parent-Cafe
You might also want to try using a visual timeline like this one to show your child what to expect.
Do a test run
Everything’s easier second time around, right?
Invite a friend for an overnight stay at your home so that your child gets used to how a sleepover works in a familiar environment. Then perhaps try again at the home of a close family member.
Hopefully these practice runs will help iron out any anxieties and give your child confidence for the real thing.
Make an escape plan
Let your child know that it’s ok to call you and come home if they need to at any time. If your child is feeling anxious or scared, it’s better that they know they can come home and try again another time than stay feeling worried and be put off the idea for good.
All about me
Share as much relevant information as possible about your child with the host parent before the event. Make sure they have your correct telephone number and ideally a back-up number to call as well just in case.
Include details of any medical needs, allergies and potential challenges or sensory triggers such as loud noises or food preferences. Your advice on strategies for comforting your child at bedtime and handling any flare ups will help the sleepover run more smoothly.
Time to pack
Don’t forget to pack a favourite blanket, toy or book – anything that makes the child feel comfortable which will help ease any anxiety. Ask the host parent to let your child keep to their familiar bedtime routine as much as they want to.
TomTag is perfect for making a packing checklist of all the items they need to take and a handy reminder when they need to bring everything home again too!
Let your child know you’re proud of them for giving it a go even if they needed to bail out. Tell them it’s not a failure if they did come home early and that with more practice it will get easier. Talk through what any difficulties were and make an action plan for next time.
Remember to thank the host friend and parents for helping and let them know how much you value their support.
“It’s the most wonderful time of the year” – but not for everyone.
Christmas 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.
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.
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.
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 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.
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!
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!
The NAS has compiled a list of tips to help you through the festive period.
Do you have any great tips you can share?
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!