How Can I Support my Child at Home?

It can be alarming and overwhelming hearing from your Doctor that your child has autism. An autism diagnosis can be difficult to accept and come to terms with. This is maybe a new thing for you and you may have a hard time coping with this type of condition that you don’t know much about. You may try to find new ways for everyone in the family to live together and cope with your new situation but you end up finding it challenging and depressing in spite of all your efforts.

After the shocking news of your child having been diagnosed with autism, you may feel lost and feel like not given help or guidance on what to do next. Moving on from the diagnosis can be frightening, but there are many things you can do to overcome the challenges that you may encounter with having a child diagnosed with Autism Spectrum Disorder (ASD).

 

Learn about Autism

Learning about the condition of your child will help you to be better equipped and more ready in making good decisions for your child. Educate yourself (e.g., reading books, articles, research studies about autism, joining seminars about autism, joining ASD support group, etc.) and seek a variety of possible treatment options (e.g., ABA Therapy, Occupational Therapy, Speech Therapy, etc.), ask some experts (e.g., asking BCBAs, Doctors, teachers, etc.) or other parents (e.g., joining parents group, etc.) questions, and have yourself be ready to participate in all treatment decisions.

Accept your child

You may observe that your child may be different from other children but learn and practice to accept your child rather than focusing on what is ‘missing.’ Enjoy your child’s special skills and abilities, rejoice in every small step of improvements and successes, and try to stop comparing your child to others. The gift of unconditional love, acceptance and not giving up are the things that your child needs to cope with and enjoy life.

Observe your child

Learn everything about your child. This simply means that you have to observe your child and find out the things that trigger your child to engage in challenging or disruptive behaviors or the things that will elicit more appropriate behaviors. Try to find the things that will make your child feel calmer, comfortable or what makes him/her enjoyable. In addition, try to check the things that can be stressful or frightening to your child. Understanding your child will help you to become better at solving or finding out solutions to the problems or at modifying challenging situations that you may encounter at home.

Provide a structure at home

Setting up a structure at home will help you and your child cope in any challenging situations that you may face every day. One way of creating a structure is to set up a routine using a daily schedule. A daily schedule can consist of a list of activities from morning until bedtime. You can use visual support (e.g., pictures/images, written words, etc.) on your schedule to help your child to have a clear view of what is going to happen throughout the day. In going through each activity on the schedule, as parents, you have to be consistent, be predictable and you must follow through with all your instructions or activities that you want your child to comply with. Please refer to our previous blog about setting up a structure at home.

Be part of the treatment team

 Having a child with autism can be challenging and that you need support from other professionals who are experts in helping your child reach their full potential and learn to overcome their challenges. Knowing and learning everything about autism and participating in the treatment plan are essential keys to understanding and helping your child. You may have your child receive all the therapy treatment that he/she needs (e.g., behavioral therapy, occupational therapy, speech therapy, etc.) but your child will only have a few hours of learning opportunity with them and have more time at home with his/her family.

 As parents, it is important to collaborate with your therapy team. Treatment will not end at the therapy clinic. You may feel relaxed and comfortable knowing that your child is receiving all the needed help but it doesn’t end there. The biggest part and the most important part of your child’s life is his/her home. It is the place where the child spends most of his/her time and the place where he/she starts and ends day-to-day activities.

 It is very important for you and your family to learn how to deal with your child’s behaviors at home. The key is consistency. Try to seek help or training from your therapy team (e.g., joining parent training, observing actual therapy sessions, etc.) on how to implement the behavior modification techniques in place. Being consistent means doing the same thing in the same way over and over again in dealing with your child’s behavior at home, to different environments and across people. You have to follow through at home with whatever way your therapy team handles your child’s behavior. This can include learning how to reinforce appropriate behaviors and not to reinforce disruptive behaviors.

These are just a few of the most important and basic things you need to know to help you and your family on how to support your child at home. Having a child diagnosed with autism can be very alarming and overwhelming at first. But as you journey through the challenges and enjoyable moments with your child while applying everything that you learned, life gets easier. 

Evening and Bedtime Routines

How well we sleep has a major impact on our day to day life, from how well we can remember and concentrate, to how optimistic we feel about the day ahead of us when we wake up (Ram et al., 2010). The fact is that the better we sleep, the better we feel and perform. For many individuals, a reliable routine at evening and bedtime can help bring reliability and quality to their sleep, which in turn improves the quality of their days.

A Brief Testimonial on Evening Routines

When I was young and having trouble sleeping my dad told me to get my sleep “on a schedule”. I was a rebellious teenager so I didn’t listen, at first. A few sleepless months later I finally asked my dad to explain what he meant by “getting my sleep on a schedule”. He explained that what he meant was this; first, he wanted me to decide what time I wanted to be asleep by every night. Then he wanted me to make sure that I had everything done 15 minutes before the time I set to go to bed. In order to do that I needed a routine to follow.

“But what if I don’t fall asleep?” I asked. He told me, “follow your routine and then get in bed at the time you set and don’t get out of bed until your alarm clock rings in the morning”. That seemed impossible, was I just supposed to lay there all night and pretend to sleep? It turned out the answer was, “yes”. About 2 weeks of following my evening routine and “pretending to be asleep” had me sleeping through the night. It was the routine that made it possible. I made sure that my routine stayed basically the same every night and that I had things in it that I find relaxing.

Remember Pavlov and his dogs? They got so used to hearing a bell and then tasting meat powder that they started to drool when they heard the bell, what those in ABA call “conditioning”. Essentially, the dogs associated the sound of the bell with the taste of meat. For me my evening routine became like the bell, a signal that it was time to relax and go to sleep. The above example is personal of course, but the basics of a good evening schedule apply to anyone trying to ease some of the stress of their evenings.

The Basics of an Effective Evening/Bedtime Routine

• Find the time you, or your child, needs to be in bed by

• Set a schedule that allows you, or your child, to finish all nightly tasks 15 minutes before the target time

  • This could include;

    • Finishing homework

    • Taking a bath

    • Bedtime stories

    • Doing household chores

    • Anything you or your child needs to do before going to bed

• Stick to the schedule

  • This is by far the hardest part, but it is eased greatly by an effective schedule. We will talk more about this later

  • Keep the schedule flexible and tweak it as needed

Now let’s look at each step a bit more closely

Finding Bedtime

Bedtime will be different for everyone and will depend on environmental and  personal factors (like the time that school starts or people that feel energized with just a few hours of sleep). When finding the right time for bed ask yourself some questions. How much sleep does this person need? As a general rule, kids need more sleep than adults, especially as they are growing. Common bedtimes are 7:30 - 9:30, with bedtimes getting later as a child ages. The next question to ask is, “How much time does this person need to get ready the next morning?” Some people need a long start up in the morning. If you or your child is one of these people, consider getting to bed a little earlier so that you can get up with plenty of time to get ready. 

Setting the Schedule

Everyone’s evenings look a little different. Some people eat dinner at 4 or 5 and so it might be the first item on the list for the evening routine. Others may have family members not get home from work until 8 or later and so dinner might be one of the last items on the evening routine. The order of the schedule doesn’t matter as much as there being a schedule. 

I like to schedule in what I call “blocks” of time. Let me give you an example. My evening schedule has a “dinner” block first and I have it scheduled for 6 to 7pm. That means that I can start my dinner any time between 6 and 7. That way, if I am doing something I like at 5:54pm, I don’t have to stress about stopping by 6pm. I will continue. Next I have my “hygiene” block that I can start anywhere from 7 to 9pm. My hygiene block includes all things I do for my health at night time, like taking my medication and brushing my teeth. Next is my “wind-down” block that is right before bed. I can’t start my wind-down block until I finish my dinner and hygiene blocks, and it has to be finished by 10pm. That means I am ready to climb into bed by 10:30.

Let’s look at this applied to an evening routine for a child.

It may look something like this; 

• Evening chores and homework 3:30pm to 5:30pm

• Dinner 5:30pm to 6:30pm

• Free time 6:30 to 7:00

• Bath and Story time 7:00 to 8:00

• In bed by 8:30

I try to set a relaxed and calm tone starting at Bath and Story time. What that looks like is that I don’t play loud games or do tickle fights with my kids once bath and story time starts. Instead, I provide a lot of hugs, rub their backs, and talk to them about their day.

Sticking to the Schedule

Sticking to the schedule can be the toughest part, but a good routine helps. Include things in your routine that are relaxing like nice smells, soft towels, and calm music. Spend time talking and being with your child during all parts of the evening routine possible. Sticking to the schedule means that you make sure to do everything on the evening routine by the times set. It also means that you don’t do things that are not on the schedule, like getting out of bed after bedtime. 

If this is a repeat issue for your child I suggest 2 things. First, create a bedtime pass. This functions almost exactly like a hall pass in school, meaning that the child is given the pass to get out of bed for any reason, be it a drink or a hug or to go to the bathroom. Once they have used the bedtime pass, it is gone until the next night.

Second is to explain to your kids what will happen at bedtime if they get out of their bed, and then follow through. My kids and I agreed that I would sit outside my kid’s room for as long as it took them to stay in their beds at night. The consequence for opening their door and coming out was that I would stand in front of their door and direct them back to their bed. If they didn’t respond, I would put them back in their room and close the door. 

I recommend staying calm and factual with your kids after bedtime, like a police officer that has pulled you over. Tell them what you need them to do and explain what will happen if they are unable to follow through. I used the bedtime pass with my children and found that it really helped as most of the time my kids didn’t even use it. 

Here is wishing you the best of luck in your quest for an evening with less stress!

References 

Ram, S., Seirawan, H., Kumar, S.K.S. et al. Prevalence and impact of sleep disorders and sleep habits in the United States. Sleep Breath 14, 63–70 (2010). https://doi.org/10.1007/s11325-009-0281-3

Morning Routines

Children with autism have difficulty communicating and interacting with other people. They also engage into other types of behaviors like performing repetitive activities and movements (e.g., body rocking, spinning, pacing, lining objects, etc.), become sensitive to any changes in daily routine, and have unusual responses to certain situations. Due to these difficulties and limitations, as parents, you may find it difficult to have your child get up in the morning and out of the door with the least amount of conflict.

The morning can be the most difficult part of the day. You sometimes may feel exhausted from your day-to-day work but you need to get yourself up and get ready for another day. But apart from rushing in getting the things done in the morning for work, you have to get your child up as well. But mornings are definitely tough and this is maybe the time of the day where your child may actually be defiant and at times would resort into mild tantrums to full-blown outburst in getting things done like getting dressed, making their bed, taking a shower, brushing their teeth, or eating breakfast.

So, how do we alleviate these challenging situations in the morning? One effective way is to establish a morning routine that will help you and your child cope. Routines provide predictability and help ease anxiety and uncertainty about what is happening around, thereby helping the child to have greater control over his/her environment. Following through in accomplishing the same routine every day, consistency in handling the situations and setting up clear expectations make parents feel more comfortable and make any situations more manageable. In addition, it will help your child to be comfortable in going through their daily activities as well. So, how to establish a good morning routine?

 Setting up a schedule

 As parents, you may encounter some challenges at home especially in following through with your child’s morning routines. Daily schedules help lessen some of these challenges. Before you start setting up the morning schedule, you have to know the effects of certain activities on your child. Maybe your child gets upset getting up in the morning, maybe gets overwhelmed by the noises of people around or when presented with simple directives. After knowing all those things, then you can start up a schedule that would fit your child’s needs.

 Once you’re done with the list of activities for your morning routine, it will be easier for you and your child to get through it little by little each day.  It is also vital to have parents set up your own schedule that would help you with your morning routine, particularly for working parents and try incorporating it and try to be consistent or do it in the same manner, every day.

Using visual support

Children with autism may not understand social cues, may have difficulty in following simple directives, or may struggle in dealing with any changes around them as they go into their daily activities. In addition, these children can sometimes have difficulties with sequencing. Visual support will help your child have a clear picture of sets of activities that they need to complete for a certain period of time. It’s a clear way to communicate to your child the sets of activities needed to get done before going to school or before going out for therapy sessions. Visual supports can be pictures, drawings, objects, written words, or lists that you can utilize depending on your child’s needs. The fewer and clearer choices they are given to choose from, the easier for these children in following the routine.

 In presenting visual support, be creative and try to incorporate each activity with some pictures of your child’s favorite toys or favorite cartoon characters/superheroes, etc. Because in going through with each activity on the schedule, these children can easily have a meltdown or become overwhelmed. Creating visual support that will help catch your child’s attention, especially incorporating pictures of the reinforcing item/ activity that he/she can have as a reward, will help your child to be more motivated in completing each activity.

Setting up a timer

At the start of the implementation of the morning schedule, try to set a timer for each activity and reinforce it heavily when your child finishes the activity on time. Setting a timer will help you and your child get used to getting each activity done on time. It will help your child see clearly what is happening and when. It can be hard at the start but try to make each activity fun and enticing to the child as you prompt him/her with each activity and celebrate like you won a lotto (e.g., fly the child around the room, play his favorite song, tickle or lift the child up in the air, or anything the child prefer) once done on time.

Once the child is completing each task on the specified amount of time, then you can normally run the schedule without a timer. You also need to set clear expectations on what the child needs to do and what he/she can get when the activity is done on time and not get when not able to complete the task. Be consistent and be ready to follow through with all your conditions. With each activity done on a specified period of time, then you’ll have enough to get all the activities done on time before heading out.

Setting up a sequence of activities

In setting up the sequence of activities on the schedule, try to check first the preferences of your child. It is essential to tailor it to the sequence of activities that your child prefers. Your child may prefer to do some activities first over the others. To make your child more comfortable in going through with the schedule, try focusing on their priorities.

For instance, if your child prefers to take a shower first before breakfast or the other way around, then honor it. Involve your child in setting up the sequence of activities on the schedule and once you’re comfortable with the sequence then stick to it. The child can change the sequence provided that he/she conforms to the sets of expectations in place. Remember as well to follow through.

Preparing ahead of time

It can be very difficult for you to wake your child up in the morning. Your child can easily get into meltdown or tantrums when he/she still wants to sleep more. To avoid this problem, have your child sleep early and have a consistent time for bed.

In the morning, try to get up an hour or a few minutes early ahead of time to give you and your child extra time to go through each activity without being pressured. It will help you work at your own pace and to avoid getting late for work or school.

 You can also prepare things ahead of time or the night before like picking out their clothes, preparing their snack and lunch, preparing the school bag, and more to avoid getting late and have enough time to address some behaviors that may occur (e.g., meltdowns or tantrums). So, having a consistent time (e.g., 7:00 pm) of bed and wake up time (e.g., 6:00 am) will help your child settle in a routine.

Setting up a reward system

Make clear expectations on what your child gets upon completing each activity on the schedule and what your child gets upon completing all the activities calmly on time. Make all the activities fun and motivating to the child by incorporating on the schedule the things that they can get in completing the set of activities on the schedule. For instance, if your child completes the activities on the schedule calmly before heading out, then your child can have one chocolate muffin (e.g., child’s favorite food) as his/her snack at school. The most important thing is to keep your child motivated and not feel stress out in going through with his/her morning routine.

Establishing a morning routine will not only help your child feel relaxed in getting through each activity in the morning but can also help anxious parents as routines provide predictability. For children with autism, routines help them to feel comfortable in an environment that makes them feel in control. So try to apply these strategies at home to help your child have a fantastic start of his/her day.