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.

The Benefits of an Enriched Environment: What It is and How to Implement It

Put as simply as possible, an enriched environment means that there are a lot of interesting things to do and engage with. One sentence isn’t much of an article though so let’s look at this a little more deeply, but remember this simple explanation of an enriched environment as we do.

What is the Environment?

Those in the field of ABA use the term environment a little differently; when an ABA practitioner uses it, they mean everything (or stimulus) that an individual comes into contact with and even includes things like a person’s body sensations and thoughts. Humans interact with their environment all day, from turning on the sink, to choosing, making, and eating breakfast, to listening to the radio. Let’s look at an example of a common environment and talk about it behaviourally.

Imagine a park. There can be swings, slides, see-saw’s, climbing bars, poles, anything you want to imagine. The park as an environment includes many things, what a behaviourist might call “stimuli”. All of the things in the park also have their own characteristics. You can see a slide, what a behaviourist might call a “visual stimulus”. You can touch a slide, and sense its qualities, what a behaviourist might call a “tactile stimulus”. If you put in some effort to climb the steps and slide down, you get a sensation of movement in your body, what a behaviourist might call a “sensory stimulus”. You can make a plan about what you want to do in the park and talk to yourself in your mind about it, what a behaviourist might call a “private event”. Behaviourists consider all of these things to be part of a person’s environment.

Humans tend to experience their environment a few ways; 

Motor

Humans can use their body to interact with their environment. You can sit on a swing and push myself. You can pick up a fishing pole and bait and cast it. You can swim in the ocean or walk on the sand. Humans tend to prefer to do things with their body that challenge them without being too difficult. It is also important to note that different people like to do different things and like different levels of challenge.

Cognitive

Humans also use their mind to interact with their environment. You  can make a plan for dinner. You can make a plan for college. You can see a problem in your environment and make a plan to solve it. You can solve a word find. Humans tend to prefer mental tasks that are new and challenging, but not too difficult. Different people like to use their minds in different ways and like different levels of challenge.

Sensory

Humans experience their environment. Everything we do makes us feel something. When you take in a deep breath. When you twirl your hair. When you eat a big meal. When you shout for joy. When you shout in anger. These things we feel in our bodies can either be pleasant or unpleasant. Humans tend to do things that feel pleasant to them and avoid things that feel unpleasant to them. What each person finds pleasant or unpleasant varies from person to person.

Enriching the Environment: Why Bother?

Hopefully by this point some of the benefits of an enriched environment are clear, but is it worth the extra effort? Scientists in the fields of ABA and Neuroscience have studied the effects of an enriched environment and have found that it can improve health outcomes and reduces stress (Francis, et al., 2002).

How Do I Enrich My Environment?

To enrich an environment means to fill it up with a variety of new and favorite challenging things to engage with, either with our bodies or our minds. This can look all sorts of ways, but for now just think about your favorite place to be entertained. What makes that place so entertaining? It probably has many things to engage with that are either new, or pleasantly familiar and you know exactly how to do the things you like best there. You can use that place as a very basic template for what an enriched environment looks like.

An enriched environment is a place where you are known, can feel safe, and have a lot of opportunities to do and experience things that you like. It can take some experimentation to find out the right activities and the right balance for each person, but the work is well worth it. Here are some tips;

Making Old Things New

One way to enrich the environment is to engage with old things in new ways, or to show a person something they didn’t know about a thing they like. Let’s look at some examples;

Have you ever made a space-ship out of a washer box? Built something new with LEGOs or blocks? Picked up something that wasn’t a telephone and pretended to talk on it? All are examples of enriching the environment by using familiar things in new ways.   

Have you ever taught someone how to do something? Tie their shoes, log in at work, or make a sandwich? The interaction between 2 people while learning something new, or something new about something old, can be a very rewarding and enriching experience for both the student and the teacher. 

Being a Sportscaster/Cheerleader

Another way to enrich the environment is to fill it up with interesting and supportive language. Essentially you become a narrator for the person you are taking care of. Let’s return again to the example of going to a park. You can describe what the person is doing as they do it, and make it fun and interesting. It is an opportunity to be the narrator of the person’s story. For example if the person is playing on the slide, you can enrich the environment by saying, “I can see you climbing up the slide! You are so fast! And… Whoosh there you go down the slide! Wow, you look like you are having fun.”

Wrapping Up 

The main idea is that you provide interesting and pleasant options in the person’s environment and then engage with the person in some of the activities. You act as a sort of narrator and guide as they experience the different things their environment has to offer. It is very rewarding to enter into someone’s world and show them all of the wonderful and interesting things about it. Good luck enriching!

References

Francis, D. D., Diorio, J., Plotsky, P. M., and Meaney, M. J. Environmental Enrichment Reverses the Effects of Maternal Separation on Stress Reactivity,

Journal of Neuroscience, 15 September 2002, 22 (18) 7840-7843; DOI: 10.1523/JNEUROSCI.22-18-07840.2002

How can Parents Implement a Structure at Home?

Most parents struggle with handling children diagnosed with autism at home. They often have difficulty in getting their children to follow a regular schedule. They encounter a lot of challenges almost every day like a child throwing into tantrums waking up in the morning for school, brushing teeth, dressing, feeding, transitioning, and more. Sometimes, parents find these challenging situations overwhelming. Dealing with children with those disruptive behaviors can be frustrating and really can test the patience of parents.

 There are ways to address this problem and one way is to create a structure at home. Creating a structure at home will help you to be in control of the situation and help the children learn to get used to their daily activities without resorting to challenging behaviors.

 How do we create and implement a structure at home? You have to create a routine for your child to follow every day and implement rules. Routines teach children what to expect throughout the day. You can create a daily routine by setting up a visual daily schedule of activities. Setting up rules and clear expectations in going through each activity on your daily schedule are very important. It will teach the children what behaviors are acceptable and not acceptable. How do we make this work? There are few ingredients to make this work.

Consistency

After setting up the routines and rules at home, it is vital for you to implement all of this consistently. It means that you need to go through it each day in the same way regardless of the changes of situations that you may encounter at home. At times, as parents, you may be really tired from a stressful day at work and here comes brushing time at night where your child gives you a hard time. You must respond to your child’s behavior the same way every time regardless if you are tired or not, if you are sad or happy, etc. Challenging behaviors are less likely to occur again if you use the same consequence. For example, you don’t give the iPad or the toy train not unless the child brushes his/her teeth and the same thing happens when the child doesn’t put his/her clothes in the hamper. You do this even if you are tired and sleepy every time it happens. 

 This goes the same thing when your child is complying with all the routines and rules in place. Don’t forget to reinforce every moment your child is calm and just following your instructions. Reinforce heavily as if you are the happiest mom/dad in the world. Be consistent as well in giving reinforcement no matter what you are going through or what you are feeling. Like for instance, you reinforce the child each time he/she puts the utensils in the sink or puts away his/her toys. You do this even if you are busy with some other house chores and make an effort to give time to praise the child. Your consistent response to each behavior will help those behaviors happen more often.

 Predictability

Daily routines and rules help children with autism know what to expect for the day and know how parents or other family members will react to their behaviors. Setting up daily routines and clear expectations will help these children know what is expected and what is going to happen. For example, your child knows that if he throws the toys instead of putting them away, no iPad. Another example, your child knows that after dinner, he/she needs to take a shower, put on sleeping clothes, brush teeth, and 5 minutes time with the iPad before bedtime.

 Follow-through

Following through is having the child do and complete a demand (e.g., brush teeth) before he/she can have the preferred item (e.g., iPad). You follow through using prompts (e.g., physical prompt, visual prompt, gestural prompt, model prompt, etc.) if the child is not complying. The child can only have the reinforcing item/ activity or can only move to the next activity on the schedule until he/she completes the given task.  Parents must do what you say you will do in response to the child’s behavior. If you say that the child can only have the iPad after brushing his/her teeth then don’t give in and give up to those challenging behaviors that you may face (e.g., throwing the toothbrush, running out from the washroom, etc.) and don’t give the iPad if brushing teeth is not done. If the child complied with the instruction right away and he/she finished brushing his/her teeth, then reinforced heavily by praising the child ‘Well done brushing your teeth.’ and giving the iPad immediately as promised. To be consistent and predictable, we need to follow through. Follow-through is crucial in both good and challenging behaviors.  

Setting up routines and rules at home will help children with autism and their families cope with various challenges they may encounter every day. Consistent routines and rules for these children help create order and structure their day, which makes their life more predictable. A structure at home will help these children learn to follow the routines and rules accordingly specifically if parents follow through, and if they are consistent and predictable. Things will go more smoothly when both parents and the child know what to expect.