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Help autistic children manage changes to routines with TomTag visual supports

My autistic son Tom (the inspiration for TomTag visual schedules) struggles with changes to his routines. His autism means that he perceives the world differently to other people. For him, the world can often seem a strange, unpredictable, and confusing place. It is understandable why he craves the stability and predictability of repetitive routines and activities, and the comfort of familiar food.  However, as a wise man once said, the only constant in life is change. Learning how to be flexible and less rigid about routines is a crucial life skill. It is one that Tom has developed over the years, with the help of visual supports.

Visual schedules are a great tool for teaching flexibility around changes to routines.  This may seem surprising – surely a schedule means sticking to a repetitive routine? However, it’s not the visual schedule that makes changes to a routine difficult but the way it is used.⁣

In this blog, I’d like to share with you an approach you can use with TomTag visual schedules to help your child be less rigid and more tolerant of changes to their routines.

Use a schedulered tomtag button holder with symbols in sequence for morning routine

Make sure that your child understands how their schedule works and uses it regularly. If your child doesn’t  understand their schedule or use it regularly then it is unrealistic to expect them to deal with changes to it.

Need some support  introducing visual schedules ? The TomTag Show me how:Timetables and routines guide can help. 

I am flexibleGrey button holder showing buttons for change of routine activity

A TomTag I am flexible tag is a great way to introduce your child to changes to routines when used alongside their normal routine tag. Using the format ‘instead of ‘  …  ‘I am flexible’…  is a simple visual way to familarise your child with a proposed change in their routine.

Words can have a powerful effect.  I am flexible is a positive affirmation that will  give your child  a sense of achievement and boost their self esteem.

 

Start with positive changesred and grey tomTag button holders showing symbols for changes to routines

Start with something positive, for example, a change to a preferred activity or food choice.

In the examples shown- sand play instead of inside play, fish fingers instead of pizza (go with the preferred activities/ food choices for your child!)

Start with a change that is not upsetting. This also reinforces the idea that a change does not always have to be negative.

Giving initial warningsTwo purple and one grey TomTag button holders showing symbols for a morning routine with a change of activity

Although the aim is to get to a stage when you don’t have to give warnings  about changes – life is unpredictable after all – you shouldn’t expect your child to immediately accept changes without doing the necessary groundwork. 

Like all new skills, the best way to learn is to break the skill down into small sequential steps. 

  • Refer to their morning schedule tag and show them the proposed change. In this example, if their morning routine shows inside play then show them the I am flexible tag with the new play activity at the earliest opportunity e.g. before breakfast.
  •  Ask them to change the activity on their schedule to the new activity themselves. Our symbol packs include 2 copies of every symbol so you don’t have to worry about running out of symbols. Their morning schedule tag now shows the new activity.
  • Keep the I am flexible tag handy. Depending on your child’s level of understanding, a short verbal explanation of why the change has taken place would also be helpful.
  • Give another warning just before the changed activity happens. Show your child the I am flexible tag to reinforce your verbal warning. This will help them remember the change and prepare for it.

Praise and encouragementA golden star in a green box saying well done.

Praise your child specifically for handling the change well using supportive positive statements like, “I like how well you managed it when we changed the schedules” or “Change can be hard, but you are doing a great job!”

Saying “You are so brave handling that change in the schedule without getting upset!”  is particularly useful if your child is very anxious about change.

Try not to say “See it wasn’t so bad was it!” as this could belittle your child’s genuine feelings of anxiety about changes and make them feel anxious about having these feelings. 

Fade the warnings

Once your child can manage changes to their routines with warnings, start moving the warnings nearer to the time when the actual change is going to happen. 

So in the example tags  I have used above, you could move the warning about the change of play activity to later in the morning. 

Be consistent

Make sure that your child’s schedule is always accurate.

Being prepared makes changes to routines so much easier to manage. It also keeps the schedule consistent so your child knows they can rely on it.

I hope you find  this approach useful in helping your child learn to accept and manage changes to their routine.

Want to make your own schedules, routines and I am flexible tags like the ones shown in the examples here or need more advice before getting started on introducing routines or changes to routines? Take a look at the resources below or get in touch with Clare via our contact page.

Resources

  • cover image for product sticker pack early years

    Early years activities

  • Early Years Home toolkit

  • product cover image for minikit morning & evening

    I know what to expect – morning and evening

  • cover image what to expect at home kit

    I know what to expect at home

  • cover pic for early years kit

    I know what to expect Early Years

  • Primary Home toolkit

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Getting dressed – TomTag Tips to help Autistic Children learn dressing skills

Plastic yellow tag showing sequence of clothing items

 Getting dressed independently is an important life skill for autistic children. Teaching dressing skills to my autistic son required a lot of time, practice, and patience.Putting on clothes in the right order, fastening buttons and zips and tying shoelaces involves mastering many skills. Add sensory triggers into the mix and it is easy to see why it took him longer to develop dressing skills compared with other children his age.

 However, it is worth the effort. Being able to get dressed by themselves gives autistic children confidence to function independently at school and it’s one less thing for you to worry about in the mornings!

Now is the perfect time for your autistic child to start developing their dressing skills. With schools closed, there’s no pressure to get everyone fed, dressed and out of the front door in the morning so there’s plenty of time to practice at your child’s own pace.

Let’s practice!

Getting dressed takes a lot of motor skills that autistic children may need time to develop. Balance and co-ordination of movements are needed to get their limbs in all the right places. Fine motor skills help them deal with many types of fastenings. 

Improving motor skills does not have to be boring! Here are some activities you can do at home with your child to make practice fun.

  • Practice balance by making a line on the floor and step with one foot in front of the other like “tightrope walking”. You could make it more interesting by pretending that they are walking a tightrope across a river full of snapping crocodiles!
  • Work on fine motor skills with a hidden treasure hunt. Fill a tub with rice or another pulse and hide small objects such as cars, or small figures and ask your child to find them. Sand play and messy play are also activities which practice fine motor skills.
  • Therapy putty is ideal for developing the hand strength needed to manipulate clothing and fastenings.

coloured buckets fuoll of sand and tag showing choice of play activtiesUse a TomTag visual list to help your child choose their preferred activity. Our new Early Years Activities sticker pack has lots  of activities that make fine motor skill practice part of playtime.

Getting Dressed

Once you’re ready to practice dressing try ‘backward chaining‘ . This method lets the child feel accomplished every time. They start with the last step then work backward from there.

Little changes can make a big difference in reducing your child’s frustrations while dressing. Here are some things you can do to make things easier for them.

Clothes

plastic yellow tag showing dressing sequence and yellow t shirt and blu jeans

 

  • Choose trousers or skirts with elasticated waists where possible and opt for loose fitting items with velcro or large buttons which are easier to put on than tight fitting ones.
  • Use a simple visual checklist like TomTag showing what order each item of clothing should be put on. You could also lay the clothes out in the shape of a body to help with visualisation.
  • Offer a choice, “ you can wear the blue shirt or the red shirt”.
  • Lay out clothes the night before, making sure they are the right side out.
  • Organise the wardrobe separating play clothes, school clothes and ‘going out’ clothes

 socksSocks

  • Begin with large, short socks that slip more easily over the feet.
  • Show  your child how to scrunch longer socks up first before pulling them on
  • Socks with colored heels make it easier to get them the right way round. We love the brightly coloured Ez Socks  from Special Kids Company that also have handy pull up loops.
  • Try Little Grippers school socks for socks that stay on – and up! – all day long.

shoesShoes

  • Having a designated place for shoes will save valuable time spent hunting for them
  • Start with slip on shoes or use no tie elastic laces such as Hickies, Greepers and Lock Laces
  • Teach shoe tying with a  step by step approach. The ‘bunny ears’ is a popular method and YouTube is an excellent resource for demonstrations of this and other tying methods.

coatCoat

  • Start practising with different, larger types of coat.
  • If the sleeve by sleeve approach isn’t working try this flip flop over the top method  wonderfully described by Connectability.ca – you might want to stand well back until they get better at this one though!
  • Attach a zip pull or a key ring to the zip to help with gripping the tab and make zipping easier.

starWell done!

Don’t forget to give plenty of praise to your child for their efforts at each stage and consider using a star chart to help them establish their routine.

 

Sensory and developmental issues 

If your child is sensitive to clothing consider how to reduce their sensory triggers .

Check for labels and seams that might cause irritation and cut them out where possible. Wash clothes several times before wearing to help  soften them. 

The Sensory Smart Store started by a mum of an autistic boy with sensory processing disorder has a great range of clothes to help sensitive and sensory children and adults. Whilst EcoOutfitters offer school clothing made from 100% pure organic cotton.

Dressing in front of a mirror provides important visual cues that can help a child with sequencing, body planning and body awareness. If your child continues to have difficulty with dressing, a qualified occupational therapist should be able to help.

Have you any tips or experiences to share about teaching dressing skills? We’d love to hear from you in the comments below.

Resources

  • I can do it – self care skills

  • cover image what to expect at home kit

    I know what to expect at home

  • cover image download school morning routines

    School morning routines

  • cover image sticker pack self care

    Self care

 

 

 

 

 

 

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The Challenge in Challenging Behaviour

If someone cannot tell you how they feel they will try to show you how they feel.

Language is one way to convey emotion, but of course it is not the only way: sign language and symbol communication systems such as TomTag feelings tags are equally as effective. People will express their feelings through their behaviour when they either 1) do not have a communication strategy to hand, or 2) when they themselves cannot identify the feelings they are experiencing.

You will have heard the phrase challenging behaviour. And you will have come across the common misconception that it should be stamped out. The behaviour is communication, we do not want to stamp that out.

Consider what the challenge actually is:

  • The person exhibiting the behaviour is being challenged by a problem in their own life.
  • The challenge they are setting you is to work out what that problem is and to help them solve it.
  • Their behaviour is simply the communication tool they are using to alert you to the problem.

When faced with behaviours that challenge you, if all you do is try to prevent the behaviour you will not escape the challenge. Suppose the behaviour I am using to express my difficulty with the world as I find it is to hit my head against a wall, and you put a helmet on me to stop this from hurting me. Although my head is safe you have silenced my communication, so I will need to find a new way to express the difficulty, perhaps I will bite myself, or hurt you. I am not doing these things maliciously, I am just seeking to be understood.

Helping me to recognize and then express my emotions using communication strategies such as signs or symbols gives me a way to express my difficulties clearly to you without needing to resort to challenging behaviour. You need to ensure these communication methods are as effective as behaviour for me, I want to be sure that I get as much help when I point to the symbol for ‘sad’ as I used to get when I expressed ‘sad’ by hurting myself.

The word challenge is right. It is a challenge to work out what someone else is communicating to us, especially when we are trying to do that for someone who doesn’t communicate using traditional communication methods or for someone who experiences the world in a different way to us, due to sensory differences or neurodiversity.

On my course Exploring the Impact the Senses have on Behaviour, we do just that! When behaviours stem from sensory causes they require a different response from behaviours whose origins are elsewhere. Behaviour triggered by the senses can be low level niggly gripey grumpy type behaviour or it can be big explosive behaviours such as biting, kicking and lashing out.

When explosive sensory behaviours occur hormones flood the brain and a person loses access to their ordinary channels of communication; language, signs and symbols no longer work. On Exploring the Impact the Senses have on Behaviour we look at how we can communicate in a sensory way to support that person. We look at how practices such as externalizing emotional regulation and using symbol support (e.g. TomTag) to express emotion can help avoid crisis situations. We also do the sensory detective work to better understand the triggers for these behaviours and how we can avoid them.

Connect with Joanna to learn more about her remarkable work and brilliant, interactive, training courses.

TheSensoryProjects.co.uk

Facebook @TheSensoryProjects

Twitter @Jo3Grace

Linkedin Joanna Grace

  • cover image sticker pack feelings & emotions

    Feelings & emotions

  • cover image download feelings tag

    Feelings tag-o-meter

  • I can do it – manage my feelings

  • cover image for share how I feel minikit product

    I can do it – share how I feel

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Back to school – help with anxiety and organisation

school girl carrying rucksack with packing checklist attachedYou’ve got the uniform, the new shoes, pencil-case and stationery and they’re all neatly labelled with your child’s name – but being ready to start or go back to school isn’t just about having all the right kit.   

Starting school for the first time, going to a new school or moving to a new class, teacher or environment are some of the biggest transitions in a child’s life. It’s normal to feel anxious or worried at times of transition or change and the routine and environment of daily school life can present many challenges in itself for some children. It can often be difficult for children to understand and express these feelings and know how to cope with them effectively. If a child can share their worries and concerns with their parents and teachers it will be easier to help them develop good coping skills and strategies. 

My TomTag Feelings Notebook is an ideal tool for communication between child, parent and teacher. It helps a child to express, understand and communicate their feelings and anxieties. Parents and teachers can better understand the causes and triggers for a child’s anxiety or behaviour, by identifying patterns over a number of days or weeks. This written record can help them to work in partnership to give a consistent and coordinated level of support to the child. 

The TomTag Share how I feel tag and Manage my feelings kit are additional complementary products that can be used in conjunction with My TomTag Feelings Notebook to help a child further explore, express and understand their feelings and emotions.

The brand new lunch box you bought just a few weeks ago gets left on the kitchen table in the rush to get everyone to school on time – what now? Arriving at school without all the right kit for the day ahead is a common cause of anxiety and stress for many school children. Not being able to take part in activities, being in trouble with teachers, not being comfortable and having attention drawn to them are all unwelcome consequences of forgotten pe-kits, lunchpacks, jumpers and the like. TomTag’s I can do it – pack my bag for school kit is a simple checklist that attaches to a child’s school bag to remind them what they need to take to school and bring home again each day.

We’ve created some new amazing value bundles incorporating all these products to help you prepare and support you child as they head back to school or if they’re starting school for the first time. Click on the product links below to find out more about each product and details of our bundles. 

  • cover image feelings notebook extra stickers

    Extra sticker sheets for Feelings Notebook

  • cover image sticker pack feelings & emotions

    Feelings & emotions

  • cover image download feelings tag

    Feelings tag-o-meter

  • cover image for back to school bundle products

    I can do it – back to school bundles

  • cover image for feelings bundle product

    I can do it – feelings bundle

  • I can do it – manage my feelings

  • I can do it – pack my bag for school

  • cover image for share how I feel minikit product

    I can do it – share how I feel

  • cover image sticker pack my school kit

    My school kit

  • cover image product feelings notebook

    My TomTag Feelings Notebook

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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.

  • cover image sticker pack christmas & birthdays

    Christmas & birthdays

  • cover image download christmas

    Christmas survival guide

  • cover image what to expect at christmas kit

    I know what to expect at Christmas & birthdays

 

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School morning routines

Getting the whole family ready for school and out of the door on time and with all the right kit is never easy. There’s usually lots of shouting, nagging and panic involved!

Chaos or calm?

A less stressful and chaotic morning is possible with a little preparation. When children have the skills to get ready independently, they can start to take responsibility for themselves and their belongings without needing you to remind them every time. It might take a little practice and patience at first but it will be worth the effort in the long run.

Establishing a consistent morning routine (and the evening before) is also key to getting things to run more smoothly and helps everyone to understand what’s expected of them.

Visual checklists and schedules are an ideal tool to use when helping your child learn routines and skills for independence.

Use a consistent morning routine

Getting back into a routine after a long break or when starting school for the first time can be really difficult, especially for very young children or those on the autistic spectrum.

Create a visual reminder of all the tasks that need to be completed each morning and list them in the order in which you want them to be done.

It’s ok to use more detailed steps at first or attach a separate detailed list for each task to help make the process easier to understand.

Keep this list in a handy place in your child’s bedroom so it’s within reach when they get out of bed. Get them used to following the routine step by step each morning and work towards them checking things off independently each day.

Avoid the dressing battlefields

self care i can rememberKeep another checklist in the bedroom that will show your child what clothes they need to wear and what they should put on first. This avoids the pants over trousers scenario!

Setting out clothes the night before saves a lot of stress trying to find clean clothes in the morning. Start by laying out all the clothes for them so that everything’s ready to go the next day and then build up to them taking the responsibility for preparing this themselves.   

Tackle hygiene skills

self care follow instructionsTaking care of personal hygiene is a very important life skill for all our children to learn. We perform these tasks for ourselves everyday without needing to think about exactly what we’re doing.
For children just learning these skills, we need to break the task down into smaller steps. A picture list describing each step in the process is a great visual reminder that they can refer to each time they do the task which will help them to master getting it right.
Keeping a teethbrushing, toilet routine or washing checklist in the bathroom will help your child develop the independence to get ready in the morning by themselves and speed up the whole family’s routine.

Pack all the right kit

pack for school carrying bagGiving your child the responsibility for finding and packing everything they need for school might seem like a crazy idea but even the youngest or most disorganised child can soon get the hang of it, increasing their independence and reducing anxieties that occur over forgotten items.
Use a simple checklist attached to their schoolbag listing all the things they need to remember to take for each day of the week. Then they’ll also have it with them at school to remind them what to bring home at the end of the day too.
Getting into the habit of packing the night before is a great way to avoid that last minute panic searching for homework or games kit in the morning when you really should be leaving the house!

Make your own schedules and checklists

  • product cover teeth minikit

    I can do it – brush my teeth

  • I can do it – pack my bag for school

  • I can do it – self care skills

  • product cover image for minikit morning & evening

    I know what to expect – morning and evening

  • cover image what to expect at home kit

    I know what to expect at home

  • cover image sticker pack my school kit

    My school kit

  • School bag with TomTag checklist attached

    Organising my school bag

  • cover image download school morning routines

    School morning routines

 

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New school year, new start with TomTag

Looking forward to the children going back to school but dreading those chaotic school mornings?

Help your kids learn to get themselves ready for school, know and understand their own routine and remember what they need to pack – with less nagging from you and a lot less stress all round.

It really is easy with a little help from TomTag!

  • cover image for back to school bundle products

    I can do it – back to school bundles

  • product cover teeth minikit

    I can do it – brush my teeth

  • cover image for feelings bundle product

    I can do it – feelings bundle

  • I can do it – pack my bag for school

  • I can do it – self care skills

  • product cover toilet routine minikit

    I can do it – toilet routine

  • product cover image for minikit morning & evening

    I know what to expect – morning and evening

  • cover image what to expect at home kit

    I know what to expect at home

  • cover image sticker pack my school kit

    My school kit

  • cover image sticker pack self care

    Self care

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TomTag: your stories – Elizabeth

We learn a great deal from listening to our customers about their experiences with TomTag. It’s always interesting to find out about the different ways they use our products and wonderful to hear how it often makes such a real difference to their lives.

We thought it might be helpful to share some of those experiences and ideas with you too so we’ve interviewed a number of our customers who have been kind enough to talk about their different stories and backgrounds with us.

First up is Elizabeth, a childminder from London, and mum to two girls aged 4 and 12. 

Why did you purchase TomTag?

I bought TomTag to use with my daughters as both girls are on the autistic spectrum. Although they are both verbal and relatively high functioning they still need some support with their daily life activities.

I’d describe my youngest daughter as being in a permanent ‘fight or flight’ mode, always needing reassurance about what to expect during the day. The eldest has executive functioning issues and needs support to help her sequence activities and with organisation.

Did you use any other type of visual supports before you tried TomTag?

I used to make my own picture timetables and sequences. It was very time consuming having to print off the pictures, laminate them and then attach them to Velcro. My youngest daughter really didn’t like the Velcro system so when I saw TomTag advertised in Aukids magazine I decided to give them a try.

So, how do you use it?

In lots of different ways! 

For my younger daughter I have set up:

 

 

  • daily timetables that I create by prominently displaying 3 tags on hooks on the fridge (and also in the other rooms where she needs to use them) to show her what her morning, afternoon and evening routines should be
  • a toilet routine reminder hanging in the bathroom which is a simple picture sequence checklist to break the routine down into small steps.
  • social story resources to help prepare for things like visits to the doctor and hairdresser. I explain what’s going to happen and the order of events whilst we look at the pictures together.

My elder daughter uses TomTag for: 

Younger child tag examples

How has TomTag helped your children?

My little one finds TomTag very comforting. She feels in control of her day now and is less anxious about what is going to happen next. Seeing her routine in pictures also helps with teaching her sequences and time concepts. She loves the ‘hands on’ system – she particularly enjoys clicking the buttons in and out!

My older daughter finds TomTag really helps with her organisational skills. She feels less anxious at school knowing she has all the right things with her. She also likes the ’hands on’ nature of TomTag and she’s now started taking responsibility for planning and organising her day. For example, when she started going to choir as an after school activity, she changed her tag by herself to show this change of routine.

I’ve also found the tips and advice for teaching life skills on your website very helpful.

Do you have any suggestions for how we could make TomTag even better?

The range of images supplied in the various sticker packs is generally good. I have used the blank stickers to draw some personalised images – an umbrella, keys and phone charger.

I think there could be some additional ‘days out’ type images e.g. summer fair, fun fair, adventure park or castle. Perhaps a jumbo version of the tags and buttons would be useful for children who have sight problems but I appreciate the product would not then be as portable!

Overall I think TomTag is a wonderful product and it has really made life easier for both my daughters.

Thank you Elizabeth for sharing your story and for giving us some insightful tips on how TomTag works in your home.

Follow the highlighted links in the interview to find out more details about all the products used by Elizabeth and her family.

Would you like to share your story with us?

All it takes is a short chat with us on the ‘phone, ideally send us a few pics of your TomTags in use then just leave the rest to us. It’s easy to get in touch with us, all the details are on our Contact Us page. 

 

 

 

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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.

  • cover image sticker pack haircuts and health checks

    Haircuts & health checks

  • cover image kit at appointments

    I know what to expect at appointments

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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.

  • cover image sticker pack at the shops

    At the shops

  • cover image sticker pack food drink basics

    Food & drink basics

  • cover image sticker pack food and drink extended

    Food & drink extended

  • cover image download going shopping

    Going shopping

  • product cover help at shops

    I can do it – help at the shops

  • I can do it – independent living

  • cover image what to expect going shopping

    I know what to expect going shopping

  • cover image sticker pack my shopping list

    My shopping list

  • cover image sticker pack out & about

    Out & about

  • cover image sticker pack shopping for clothes and shoes

    Shopping for clothes & shoes