Dealing with change
Young people with autism can find change particularly stressful. Due to the behavioural, information processing and sensory aspects of their diagnosis, young people on the autism spectrum often prefer familiar environments with a predictable routine. Restricted and repetitive interests, sensory processing differences and heightened anxiety can make even small changes stressful. Planning ahead and preparing a young person for changes in their everyday routines and activities is important:
“Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights… Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life. Trying to keep everything the same reduces some of the terrible fear.” 1
Preparing young people with autism for upcoming changes is referred to as “transition planning”. The purpose of transition planning is to enact change in a way that feels safe and predictable for the individual on the autism spectrum. Effective planning helps reduce stress and anxiety and helps prevent behavioural issues that may occur as a result of unexpected change.
Some everyday changes or new situations a young person with autism may need preparation for might include:
- leaving the house
- having visitors at your house
- going somewhere new, such as the dentist
- switching between activities or tasks during play or learning
- doing things in a different order from time to time – for example, having a bath/shower before dinner rather than afterwards
- eating new foods
These frequent changes that may occur on a daily basis are known as horizontal transitions.
Every day changes and “horizontal planning”
Visual strategies build on children with autism’s strong visual learning and thinking style and can be an effective way in which to communicate upcoming changes. Common visual strategies used in horizontal transition planning include Social Stories , task lists, schedules such as timetables, daily planners and calendars. The National Autistic Society (UK) have published a thorough information sheet on the various uses of visual supports.
When visiting a new place having photos to prepare the individual of what to expect can be helpful. Pictures can be obtained through websites or by exploring a location via the Google maps street view function. Requesting images may also be an option, for example, contacting the doctor’s practice and requesting a recent image of the doctor and or the consult room in advance of the appointment. The use of smart phones can increase the accessibility of some methods.
There are an ever increasing number of apps that can help with challenges faced by young people with autism. The Autism Association of Western Australia has developed an online resource, Autism Apps, that offers information about:
- how to use an iPad effectively
- how to support people with autism using technology
- tips for selecting a useful app
- Information related to the National Curriculum and Evidence Based Practice for supporting individuals with autism.
Longer term changes and “vertical planning”
Progressions from one life phase to another are known as vertical transitions. The progression form primary school to high school is an example of a vertical transition experienced by children in the middle years. The Amaze/Autism Tasmania information sheet, Effectively Preparing Individuals with Autism Spectrum Disorder for Transitions, provides a list of general strategies to help individuals with autism transition to new environments. The information sheet can be downloaded in full from the Autism Tasmania website.
Jollife, et al (1992) in Howlin (2004), ibid, p.137.↩