Image: Stuart Miles / FreeDigitalPhotos.net

When out for lunch one day, a lovely older couple and their daughter sat down in a booth near us. They went up to the buffet to fill up their plates as a family, and the daughter returned to the table first.  She sat down, put her plate on the table in front of her and quietly waited for her family to return to the table so they could all start eating their lunch together. Oh, and did I mention that their daughter had Autism?

Witnessing this, I wanted to go up to her parents and just hug them. I didn’t of course, as that would not have been socially acceptable. Instead, I decided to write about the experience.

Children with Autism can be very picky eaters, so I understand why manners tend to take a backseat at mealtimes. Parents would rather focus on getting their child to eat their veggies than harp on table manners.  After all, is it that important to teach your child to wait to eat his meal before the rest of the family sits, or to stay at the table until everyone is finished eating?

While it’s true that we have to pick our battles, it is still important to teach children with Autism the social skills that they need and can carry with them the rest of their life. The difference between your child requesting a “drink” and “drink please” may seem like a small one, but people really do respond better when we say our “pleases” and “thank-yous.” So if your child already mastered the word “drink,” you might as well throw in “please” for good measure.

Here are a few manners that could really benefit your child.

1. Saying please and thank you.  If your child is non-verbal, teach him sign language for these polite words, or encourage the use of symbols. While it is more important to teach your child functional requests, such as bathroom, drink, food, etc., there is no harm in adding a please and thank you; it makes a practical difference and turns demands into polite requests.
2. Holding doors for other people. This simple skill promotes an awareness of others.  It teaches your child to look around and check if someone is walking through the door behind him.  Holding the door open will also cause others to say thank you, which will reinforce your child’s thank-yous, too.
3. Not interrupting. You can practice this skill during mealtimes at home.  You can give your child a wait symbol while you are speaking to someone else at the dinner table. Pair the symbol with the verbal command, “Please wait. I am talking.” When it is his turn to talk, take the wait symbol back and say, “Okay, now it is your turn.”  You could also try giving your child the wait symbol when you are on the telephone.  When you get off the phone, take the symbol back and say, “Your turn.”  Teaching your child to wait while others are speaking is a life skill that will benefit both you and your child.
4. Staying at the table until everyone is finished eating.  Wouldn’t it be nice to be able to finish your entire meal because your child is still sitting at the table?  Of course, I understand that some children just can’t sit for long periods of time due to sensory issues, but perhaps you can start by encouraging this skill while having a one course meal of pizza.  Teaching your child expectations is an important ingredient in the social skills recipe.
5. Waiting until everyone is served before starting to eat.  Many manners in our society are best practiced and learned during mealtimes.  Any activity that involves waiting is a wonderful learning opportunity for your child.  Your child will learn to look at others and notice what others are doing.  He will learn to be more aware of his surroundings and he will learn how to be patient.  Waiting for others also improves impulse control.
6. Saying sorry, or excuse me, when bumping into someone.  Many children with Autism have a poor sense of where their body is in space. They may bump into walls, furniture, and other people.  If this is your child, he may not even realize that he has just knocked into someone. This is when you can say, “Jack, you just bumped into this gentleman. Please say I am sorry.”  If your child is non-verbal, you can carry “excuse me” symbols with you, and you can ask him to hand the symbol to the person he bumped into. Saying sorry, or excuse me, is a good practice for your child, and will help him in a variety of social situations.

Setting boundaries, guidelines, and expectations gives your child a road map to how to behave in different social situations.  Teaching manners may seem like a tedious task at first, but you and your child will be grateful for it in the end.  You will be giving him the tools that he needs to be a successful part of society, and because of your perseverance, you will be able to sit, relax, and enjoy your lunch in a booth in a restaurant in the middle of the afternoon with your family.  Manners matter!

      Stuart Miles / FreeDigitalPhotos.net 

Do you relate to this scenario?

It is 8:00 p.m., and your 7-year-old son is bouncing off the walls.  He is overtired, had a long day of school and therapy, and is bumping into things, bouncing on the furniture, and repeating videos aloud.  You think to yourself, “How in the world am I going to get this boy to sleep tonight?  I don’t want him to be exhausted tomorrow.”  So, you say to him, “Tommy, go jump on the trampoline for 15 minutes.  First trampoline; then bed.”  Your significant other says to Tommy, “Why don’t you go lie in bed and watch a movie? That will calm you down.”  You look at your partner in disbelief, but are too exhausted to fight, so you say, “Okay.  Go get in bed and watch a movie.”

What just happened here?  You wanted Tommy to jump on the trampoline because you know that jumping tires him out and gets all of his energy out.  Your partner thought it would be better for him to lie in bed and watch a movie, because movies keep Tommy quiet. However, you don’t want Tommy to watch a movie, because that sometimes makes him wake up in the middle of the night reciting scenes from the film.  You have had this discussion before, but tonight is not the night you feel like discussing how your partner is not on the same page with you.

Here is another scenario:

Your daughter Becky is on a gluten-free, dairy-free diet.  Whenever she eats anything with gluten or dairy, she gets agitated, is awake all night, and gets bad eczema.  Your mother (Becky’s grandmother) offers to take Becky to the park one Saturday.  You are thrilled to have two hours to yourself.  You don’t think to remind your mother of Becky’s allergies, because she is fully aware of Becky’s diet.  Out the door they go for a few hours at the park.  They come home a little later and Becky is beaming from ear to ear.  She had so much fun with her grandma.  You continue your day, sticking to Becky’s schedule, which includes playing with Legos, Play-Doh, walking the dog, and going out for dinner with the family.  As the day progresses, you notice that Becky is very agitated. She rocks back and forth more, and does not engage in conversations with you at dinner.  You hope that she is not coming down with something.  That night, Becky doesn’t sleep at all.  Little did you know that Becky’s grandmother gave her a “little” treat.  It was just a small cup of ice cream.  Surely, such a small amount couldn’t harm her granddaughter.

It is very important to be on the same page with everyone in your family.  I know this can be a challenge, especially if your parents rely on their experiences (because they raised you and you turned out so great), or your partner thinks he or she is right.  Let’s take a moment to acknowledge that your family’s reasons for doing things a certain way is well meaning. They love you.  They are sincere in thinking they are helping.  They want to make your life easier.  They love your child, and think they are being supportive.  However, raising a child with Autism takes more than that.  It takes consistency, sticking to a routine, adhering to a plan, and being on the same page.  Here are some steps you can take to get there.

• Communicate. The first step is to have a conversation and let everyone involved in your child’s life know how you feel.  This is not going to be easy, but you can do it.  If it is easier for you, you can also write a letter to communicate your feelings. Either way, you should communicate the following: “I know that you love my son and me.  I know that you are trying to help me, but I need you to know what I need right now.”  Also talk to your partner, and tell him or her how you are feeling and what you need to feel supported.

• Inform and explain. The next step is to inform yourself and become clear about what Autism is so that you can explain it to other people in your family.  You can also direct them to these websites:

http://www.autismspeaks.org/what-autism

http://www.definitionofautism.com/

http://www.autism-society.org/

• Profile your child.  Design a profile of your child; include his strengths, challenging behaviors, sensory issues, allergies, activities that he finds reinforcing, rules, and consequences for breaking the rules.  Keep in mind that different places and different people tend to have different rules.  This is okay as long as the major rules stay intact.  For example, the rule “Keep your hands to yourself” should apply in every situation. If you feel a certain rule is non-negotiable, make that clear.  Establish the rules with the people in your child’s life ahead of time.  Then, be sure to review those rules with your child every time he is with another person or going to a place that has different rules.

• Outline the consequences of broken rules.  Clearly let the people in your life know what happens when everyone isn’t on the same page and rules are broken.  Besides the obvious health and safety factors, children with Autism thrive on routine, structure, and consistency.  While some adults may think they are giving a child a break or making an activity more fun by changing the rules, what they are actually doing is confusing the child.  Generalization, the ability to carry over skills learned in one area and apply them to a new situation or area, can be extremely difficult for children with Autism.  For example, when you teach your child how to wash his hands at home, he may not know what to do when confronted with a sink in the bathroom of a restaurant.  This can be very stressful for your child.  If it is difficult for your child to remember and apply new skills across a variety of settings, imagine how difficult it would be for him to try and figure out who has what rule, when it is okay to break the rule, and when he will get in trouble for breaking the rule.  So while the people in your life who love you and your child very much think they are doing a good thing, they may actually cause your child more stress.

• Work together. Working together creates a team, a united front, and a calmer household.  While you and your partner come from different homes, parents, and childhood experiences, you both have valuable skills to bring to the table.  Your input, insight, and support are essential when raising your child with Autism.  On those days when you are frustrated and you just wish you had more support, remind those around you of what you need.  Maybe they just forgot, and thought they were doing things right.

You know firsthand from observing your child’s challenges with communication how important it is for him to communicate his desires to have his needs met.  It doesn’t matter if he is verbal (using his words), non-verbal (using gestures), or uses symbols (drawing pictures or writing words) to communicate.  You and your family are very concerned with creating a functional communication system for your child with Autism, and rightly so, as this is of utmost importance.  But how is it going with your communication system? Are you letting others know about your needs in some way, so you can get the support you need?

If you need additional support, be sure to email JenniferLingle@AutismConsultingandTraining.com to set up your free “Getting To Know You” call today.

Children with Autism are typically visual learners. They learn by seeing and not necessarily by hearing. If you find yourself giving directions repeatedly, and your child is not complying, you may want to consider using visual strategies. Even if you think your child is familiar with his schedule, your house rules, and the steps involved in completing a task, providing him with visual tools sets him up for success.

Visual tools can be picture strips, written instructions if your child reads, or a combination of pictures and words. You can use them at home, in school, and in the community. You can make your own visual tools by cutting out pictures from magazines and newspapers, or you can take photos of your child while doing a task and use the pictures in a visual schedule. At the end of this article is a link to our website where you can find more information on visual strategies and custom-designed visual tools.

Schedules
Visual schedules reinforce structure and routine. They help your child understand what is happening next in his day and help in recalling past events. You can use photographs, symbols, and/or words, depending on the need. You can try breaking up the schedule into morning and afternoon routines. Review the schedule with your child in the morning. Have him check off, or in some way visually remove each event as it is completed. This will minimize confusion, and help your child clearly know what to expect throughout his day.

1. Home schedule
Include activities such as mealtimes, bathroom time, chores, outings, quiet time, and homework time. Try including sensory activities throughout his schedule also, especially before and after in-seat activities.

2. School schedule
I hope that your child has a visual schedule at school so that he knows what to expect in that setting. If not, you can send one in for him or request that his classroom teacher create a schedule. School routines usually stay the same. However, it is still important for your child to have a school schedule to prepare him for changes (i.e. fire drills, special assemblies, playground cancelations because of inclement weather, etc).

3. Community schedule
You can minimize meltdowns in the community by showing your child photographs of places you are going. Review the pictures with him before you leave the house, before you get out of the car, and throughout your outings. Be sure to place a photograph of your home at the end of the photo series to ensure that your child understands he will come back home afterwards.

Task Strips
Post task strips at eye-level in convenient places that are visually accessible to your child. Review a task strip with him before an activity occurs. Verbalize each step while pointing to the pictures from left to right. After some time, stop saying the words and simply point to each picture to show your child the next step. The task strip will then be the only reminder he needs to complete a task. The goal is for your child to complete different chores and tasks independently.

4. Bathroom task strip
Place the bathroom task strip above the toilet paper roll in your bathroom. If you have a son, be sure to have two strips, one for standing and one for sitting. Include pulling down pants and underwear, sitting down, wiping (from front to back for girls), flush the toilet, and wash your hands.

5. Washing hands task strip
Place this task strip above the sink in all bathrooms in your house. You may even consider taking a washing hands task strip with you when out in the community to remind your child of the steps involved. Include turn on the water, put soap on your hands, rub your hands together and count to 30, rinse your hands, dry your hands, and turn off the tap.

Rules
Post rules in a convenient and visually accessible place for your child. Verbally review the rules with your child before an activity occurs, pointing to the pictures from left to right. Then review the rules again during the activity. After some time, you can stop saying the words and only point to each picture to remind your child what to do next. Always present rules positively. You can describe what is not expected, but be sure to end the rule with what is expected. For example, “Don’t hit others. NO! Keep your hands to yourself.” Commend your child when he follows the rules. Point to the rule and say, “I love the way you are keeping your hands to yourself. Good job!”

Here are some rules that you can include in your daily routine:

6. House rules
Decide on your house rules, and place the rules throughout your home. By visually posting the rules, you are reminding your child of your expectations. You are setting him up for success. You can include rules such as use a quiet voice, keep your hands to yourself, follow adults’ directions, say please and thank you, and use kind words.

7. Car rules
Car rules can include keep your hands inside the car, wear your seatbelt, sit straight in your seat, and use a quiet voice. Review the rules before you start the car. While driving, if your child is following the rules, be sure to praise him. “I love the way you are keeping your seatbelt on.”

8. Community rules
Community rules can include stay close, hold my hand, listen to me, use a quiet voice, and keep your hands to yourself. Review the rules for different places before you leave your home, before you get out of the car, and while you are in the new location. If your child is following the rules, be sure to lavish praise on him.

9. Playtime rules
Playtime rules may vary for different places. For example, when your child is playing at home the rules are different from when he is playing at the playground. Be sure to review the rules before playtime at any location. Playground rules can include wait your turn, go down the slide feet first, and stay close to Mom.

10. Work-time rules
You can use work-time rules with your child during homework time or in-seat activities. Work rules can include sit in your seat (or sit on the ball, stand at table), use your quiet (or inside) voice, and look at your paper.

For more on visual strategies and custom-designed visual tools, visit http://autismconsultingandtraining.com/autismproducts/autismvisualstrategies/

Editor: Ymkje Wideman

Twelve ways to get your child to use the toilet

By Jennifer Lingle, M.Ed.

Potty time can be very intimidating and scary for many children, and especially for children with Autism.  There are many sensory components in the bathroom experience.  The toilet seat may be cold and/or feel very hard, sounds may echo off the walls, the toilet flushing may be loud and overwhelming, your child’s depth perception may be off and he may be afraid of falling in the toilet, or he may just not like sitting down.

There are some important factors to keep in mind regarding potty time, including if your child is ready for toilet training. He may not be bothered if his pants are wet or soiled, which makes the process more difficult.  However, even if you think that your child isn’t ready yet, there is no harm with exposing him to the bathroom experience.

Here are twelve suggestions to encourage your child to start sitting on the toilet and attempt to master one of life’s most important skills.

1. Music: If your child likes music, play music for your child while he is sitting on the potty.  Make a CD of some of his favorite songs just for use in the bathroom.
2. Use a timer: If it is difficult just getting your child to sit on the toilet, bring him into the bathroom even if he doesn’t have to go.  Encourage him to sit on the potty until the timer goes off.  Continue to increase the time every few visits to the bathroom. Start with 15 seconds, then 30 seconds, 60 seconds, 2 minutes, and so on.
3. Rewards: Reward your child for every successful step of the process. If it is difficult for him to even step into the bathroom for potty time, reward him for getting two feet in the door.  If he is usually terrified of sitting on the potty, and he does so for 10 seconds, reward him!
4. Fidget Toys: Keep a container of fidget toys next to the toilet. Allow your child to hold a toy while he is sitting on the potty. Cause and effect toys also work great for potty time.
5. Schedule: Put potty time on his schedule before a desired activity. By scheduling potty time, you are letting him know that using the toilet is not an option.
6. Task Strip: Use a task strip for the bathroom, so your child can see the steps involved.  The task strip can include symbols or pictures to represent pulling down pants and underwear, sitting on the toilet, wiping, flushing the toilet, pulling up pants and underwear, and washing his hands.
7. Counting: While your child is urinating in the toilet, practice counting with him for as long as he is peeing.  Counting will help him fully release his bladder and make sure that he doesn’t get up too soon.
8. Water: Have a cup of lukewarm water ready for potty time. Let your child pour the water into the toilet.  The sound and sensory experience of pouring water into the toilet can help him make the connection to peeing in the potty. If the water is lukewarm, it won’t startle him in case some splashes onto his body.
9. Model:  Let your child model a sibling or parent.  This may be awkward, but remember that your child is a visual learner, and you cannot expect him to just “know” where his pee and poop go.
10. Targets: For boys, place a piece of cereal, or another flushable object, in the water. Teach your child to aim at the target. If your child gets distracted easily, it increases the chances of his urine going everywhere.  By giving him a target, you are setting him up for success; plus it’s fun!
11. Wiping: Once your child uses the toilet, allow him to be involved in the wiping process.  If you are worried that he may get poop everywhere, wipe his bottom first.  Then allow him to wipe.  It is important to give your child opportunities that promote self-confidence and independence.
12. Stay calm: Take a deep breath before taking your child to the bathroom. He feeds off your energy, so it’s important to stay calm.  Create a potty mantra, if needed. “Potty time is so much fun.  My son loves potty time.  I love potty time too!”  Keep smiling, and keep trying!

Teaching your child to use the toilet is a life skill that will help him for the rest of his life. Children with Autism learn by repetition, and it is going to take work, patience, and lots of practice, but once your child is successful, you will be so glad you persevered.

If you found this article helpful, please leave a comment below.  Which strategy are you going to put into place?

Editor:  Ymkje Wideman

photo credit: http://www.flickr.com/photos/valentinap/3765631910/

Your child’s teacher spends five days, and approximately 35-hours with your child each week. School is practically his second home. The teacher is there to help your child grow mentally and emotionally, and in addition to academics, she teaches your child many life-, social-, and communication skills in his classroom environment. It is therefore very important to communicate from the start and keep in contact with your child’s teacher throughout the school year to help her contribute to his progress and success.

Here are ten things every teacher should know about you and your child:

Allergies and food sensitivities: Make it very clear if your child has any allergies, food sensitivities, or has to maintain a special diet. It is very important to be specific about any negative reactions that could occur if he were to get a hold of certain foods. I will never forget one of my first teaching experiences. Eleven years ago, I had a student who was allergic to gluten. He took two pieces of candy from a classmate and ate them. The next day, his mother asked me if he had gotten hold of any food that wasn’t in his lunchbox. I hadn’t mentioned it to her, because I thought it was only two pieces of candy. He was so sensitive to gluten that he ended up being sick all night with stomach problems. I learned a very valuable lesson that day.

Behavioral strategies: If you have a behavior system that is successful at home, it is important to let the teacher know about it. If your child responds well to music, let her know if music calms him down when he is agitated, or if music wakes him up when he is tired. Tell her if you have tried using a sticker chart as a reward system and had absolutely no success with it. Perhaps you use a countdown method, where you show your child your hand and countdown from five to get a desired response, or maybe your child responds well to quiet time when he is overwhelmed and has just had a meltdown. Whatever works at home can be helpful in the classroom as well. The teacher may also be able to offer you some strategies to help you at home.

Sensory issues: What type of sensory issues does your child display? Does he rock back and forth to calm himself down? Does he sit on a special seat cushion at home that may help him at school? Maybe he has a special toy or object that he likes to squeeze that calms him down. Perhaps he uses earplugs or headphones in loud places that might benefit him in the cafeteria. Be sure to tell his teacher about any sensory techniques that work for your child.

Special interests: Your child’s teacher will benefit from knowing about your child’s special interests. You can prepare a list for her by writing down 10 activities or toys that your child likes.

Triggers: What really upsets your child? If loud noises, such as fire alarms and the school bell, are overwhelming for your child, inform his teacher. If he runs away when someone raises their voice, or when children cry, be sure to pass on that information.

Communication Tools: How does your child communicate best? Show or give the teacher any communication books or visual tools that you use with your child. If he uses photographs to express himself, be sure to give his teacher a copy of those photos.

Homework: Ask for homework to be sent home to help bridge the gap between home and school and reinforce lessons learned. Homework is also a great way to find out what your child is doing in class, and keeps you connected to the teacher. Some teachers do not send homework because they know that the work requires one-on-one assistance and they don’t want to overwhelm the parents. If you feel overwhelmed and need some strategies to help you get through homework time, ask his teacher for some ideas of what works in class. You can also contact Jennifer Lingle, M.Ed. for some recommended techniques.

Problem Reports: Do you want your child’s teacher to tell you every negative thing that happens in school? If not, let the teacher know that you are fully aware of your child’s behaviors and you would love it if her reports focused on his successes. This is not to say, of course, that you never want to know about his behaviors, but you prefer not to hear about behaviors you are already aware of every time you pick him up.

Updates: Ask for weekly, if not daily updates that include his progress, major concerns, and activities to work on at home. If you are worried about overwhelming the teacher, create a checklist for her of all the things you would like to know about each day or week. A sample checklist is available from Autism Consulting and Training, Inc. on request.

Support: Let the teacher know that you are there to support her. If she needs anything, you would like her to contact you. You are a team and want to work together to ensure your child’s success. Forming a partnership with your child’s teacher will benefit you, your child, and his teacher.

If you found this article helpful, please leave a comment!

Edited by: Ymkje Wideman

Image: luigi diamanti / FreeDigitalPhotos.net

Children with Autism tend to have very busy bodies, and may have difficulty sitting down for homework, meals, work, and sometimes even bathroom time.  Why is it so difficult for your child to sit still in a chair or on the floor? And why does he seemingly sit for a lot longer on the couch or in the car on a nice cushiony seat?

Whenever a child with Autism displays undesirable behavior, we should always think of two things:  First, what is he trying to communicate?  After all, behavior is communication. Secondly, what sensory issues are involved with this behavior, and how can we make it easier for him?

Let’s explore some possible reasons why it is so hard for your child to sit still:

1.  Communication 

Your child may be trying to tell you that he does not want to sit to do his work or eat, or perhaps he does not want to be around people.  If this is the case, try giving him the words to express himself.  After all, while we have to teach him that sometimes we have to do things even if we don’t want to, it is okay to feel that way. You could try using pictures or symbols to help him communicate his thoughts, and model the appropriate way to express himself.  If he jumps up from the table and runs away, take him by the hand, bring him back to the table, and ask him to say, “Mom, I need a break.”  It is important to state his request in the first person, so that he will repeat your exact words.  Then you can say, “Okay, go take a break.” or “I understand you want a break, but it is dinner time. First dinner, then break.”  Be sure to repeat his request verbally, so that he knows that you understand what he is asking.

2.  Sensory Issues 

• Sitting on a chair, floor, or hard surface may feel like sitting on pins-and-needles to your child.  Try placing a pillow, cushion, or seat disc on his chair.  You can find out more information  on seat discs here:  http://www.nationalautismresources.com/seating-disc.html

• If your child’s feet don’t reach the ground, it may make it difficult for him to stay still. You can try tying a Thera-Band® to the front legs of the chair. Your child can either rest his feet on the band, or push his legs against the band to provide feedback to his joints.  You can find more about  Thera-Bands® here:  http://www.thera-band.com/store/index.php?CategoryID=11

3.  Movement

All children need exercise and movement throughout the day, and children with Autism often even more so.  It helps them to be in a better mood, focus, sit still, and in general creates calmer children.  Before you ask your child to sit for an activity or meal, encourage him to move around or do some exercises.  You will be amazed at the results.

If you find something that works at home to promote in-seat behavior, be sure to share it with your child’s teacher.  These activities can often be modified for the classroom setting.

Your child does not always have to be seated to do his work. While it is important to teach in-seat behavior and have expectations for your child, it is also important to respect his need for movement.  If he is getting his homework done and stays on task, by all means, let him stand at the table to do his work.

For those times that in-seat behavior is required, here are some great exercises and activities that may help your child:

Reminder: Always supervise your child during exercise and activities that involve movement.

• Stretching
• Playing Simon Says.* This is a fun activity that teaches imitation skills.
• Bouncing on an exercise ball.  Hold your child’s hands as he bounces up and down on the ball. He may like this even better than sitting or bouncing on the ball independently.
• Jumping on a trampoline.
• Jumping rope.
• Doing jumping jacks. This is a great gross motor skills exercise and can really tire your child out!
• Doing the Wheelbarrow.  Hold your child’s feet and let him walk around the house on his hands.
• Playing freeze.  Play some fun music and encourage your child to stop when the music stops. This activity also helps with listening skills and following directions.
• Using a scooter board around the house. Have your child lie on his stomach on the board and propel himself forward using his arms.
• Swimming. If you have access to a pool, let him swim, swim, swim!  Swimming is an amazing way for your child to release energy, and can be very calming.

Remember, if your child is displaying difficulties with sitting still or does not want to sit in a chair, he is trying to communicate something to you.  There is a reason for every behavior. Respecting your child’s need for movement can be a major factor in creating a calmer household, and some of these sensory and movement solutions may just make your day run a lot smoother.

* Simon Says is a children’s game where 1 player takes the role of “Simon” and issues instructions (usually physical actions such as “jump in the air” or “stick out your tongue”) to the other players, who then carry out the instructions.

If you found this article helpful, please leave a comment!

Editor:  Ymkje Wideman

Photo Credit:  David Castillo Dominici / FreeDigitalPhotos.net

From information gathered from interviews and surveys, many parents expressed that hygiene issues are one of their biggest concerns. Children with Autism sometimes experience a breakdown in understanding the importance of cleanliness. They do not automatically understand that if they don’t shower, germs may make them sick, and when they smell bad, it is difficult to make friends. Because these outcomes may not matter to them, it is important to teach them the importance of good hygiene, and to care about being clean. Below are some tried-and-proven tips that focus on helping your child to shower or take a bath daily without you or your child melting down.

1. Place a bath or shower symbol in your child’s daily schedule.  Make sure that you schedule your child’s bath/shower during a time when she is not going to feel rushed. If your child has difficulty getting into the bathtub or shower, be patient and let her take some time to get adjusted to this transition.
2. Make taking a bath/shower part of your child’s daily routine.  Taking a bath/shower is not a choice, but a must. Just like going to bed and eating are not optional and essential for survival, bathing or showering should be a part of your child’s schedule every day.
3. Respect your child’s sensory needs.  There are many overwhelming stimulators when taking a bath or shower: the sound of running water, the water itself, the steam, the smell of soap and shampoo, etc. Bathing can cause a sensory overload for your child.  You can try different types of soaps and shampoos to ensure that your child is comfortable.
4. Create a task strip, breaking down each individual step involved in the bath or shower.  Include turning on the water, wetting the whole body, putting soap on a washcloth or sponge, etc. If your child tends to forget to wash certain parts of her body, you can include this in the task strip also.  Write down every part of the body that you want her to wash. Laminate the task strip and hang it in the shower.
5. Use a timer to either encourage your child to stay in the bath/shower longer or to get her out of the bath/shower if she tends to take too much time.  You can also try using music instead of a timer. Create a CD that she can listen to while in the bathroom for the length of her bath or shower time.  When the CD is finished, it is time to get out.
6. Remember that typically, children on the Autism spectrum have difficulty understanding the thoughts and feelings of others.  You can explain the importance of hygiene to your child by using a picture social story. Describe how others feel and what they think when someone does not take a bath or shower. Be clear about how other kids may not want to hang out with her if she smells bad. This thought process may not come naturally to your child, so using something motivating, like your child’s desire to have friends, if she cares about this, may encourage her to take a bath or shower.
7. Place a picture of a motivator or reward after the bath/shower symbol in her daily schedule.  Reward appropriate behavior with a desired activity or item.
8. Try using a chart with stars or stickers.  Clearly define the requirements for receiving a star or sticker. For example, if your child needs to wash her body with soap, write, “Wash your whole body with soap to earn 1 sticker.”  Make an agreement with your child that if she gets seven stickers she will earn a reward.  Be sure to use a very exciting reward as her motivator.

Hygiene issues can get worse as your child gets older.  The longer she goes without a strict routine to adhere to, the worse the behavior can become. However, with some organization, planning, and creative ideas, you can motivate your child to complete the desired task. Remember that your child is visual and learns from repetition, and don’t give up!  If a strategy doesn’t work the first time, or even the second, third, or fourth time, keep trying.  It will get easier!

If you found this post helpful, please leave a comment!

Create Your Own Sensory Area 

During a recent workshop, I asked my audience to raise their hand if their child with Autism did not have sensory issues. Not one person raised their hand.

Of course, not all children with Autism have difficulty processing sensory input, just as not all children with sensory processing disorders have Autism. If your child does, and has difficulty getting motivated and staying on task, or needs constant sensory input to calm him down, try creating a sensory area in your home.

Caution: Always supervise your child in a sensory area.

Benefits of a sensory area:

• It helps your child develop a greater sensory awareness.
• It promotes self-regulation. It will energize your child or calm him down.
• It encourages learning and appropriate behavior. By allowing your child to release energy in a designated space, he will be more likely to stay seated for work time or meals.
• It is a safe, comfortable space where your child can explore a variety of sensory input.
• It helps your child learn how to control any inappropriate tendencies in a safe environment.
• It promotes independence.
• It encourages communication.
• It increases on-task behavior.

A sensory area can include: 

• An area to release energy by jumping or bouncing.
• A yoga ball, air mattress, and trampoline.
• A tunnel to transition.
• A calming, quiet area.
• Bean bags, a tent, and/or a sleeping bag.
• A sensory container with different fabrics, such as satin, sandpaper, cotton, flannel, etc.
• A sensory container filled with rice, sand, or beans.

Create your sensory area in an easily accessible and convenient place in your home. Put a photograph or symbol of the sensory area in your child’s daily schedule, and encourage him to use the area before tasks that require him to sit for longer periods.

You can use the area as a reward, as a structured activity, or even as a quiet, relaxing space.  You can also try using quiet music, or fun dance music. A sensory area is a great place to experiment with activities that may motivate or calm your child.  Be creative and have fun!

Reminder: Again, please be sure to supervise all activities in the sensory area.

1.  Use visual strategies and visual tools to help your child understand her environment.  Visual strategies and visual tools are anything your child can see that assists her with understanding your requests and making sense of the world around her.  Visuals can include symbols, and/or words, schedules that show your child what to expect throughout her day, rules that explain expectations for different situations, and task strips that break down tasks into individual steps using photos.  Picture stories can also be used to help your child understand different scenarios in her life and assist in preparing her for new events or activities.

2.  If your child gets pronouns confused as she is speaking, give her the right words by stating her requests in first person. For example, if she needs to use the bathroom, she may say, “Do you need to go to the bathroom?”  You should then model the correct phrase, “I need to go to the bathroom.”  Some children with Autism tend to repeat things exactly how they have heard them (echolalia).  She learned to make the association between the question and needing to use the bathroom.  Smart kiddo!  So, now you need to replace that association with the correct words she needs to say when she needs to use the restroom.  Try stating words and sentences from her perspective whenever you help her communicate her thoughts.  So, if she is crying, try saying, “I am so sad.”

3.  Place desired items in drawers, containers, and cabinets.  Label everything by placing pictures (photographs, symbols, or words) on the outside of the drawers, containers, and cabinets.  Encourage your child to request desired items by having her use her words or by encouraging her to bring the picture of the desired item to you.  Think of everything as a communication opportunity.  Having your child bring a picture of the requested item to you, instead of pulling you to the item, promotes effective, functional communication.

4.  Sabotage situations to promote requests.  For example, give everyone a fork at the dinner table tonight except for your child.  Start eating!  When she looks at you or shows some indication that she needs something, wait for her to request a fork.  If she neither says anything nor gestures to a fork, ask her, “Do you need something?”  If she still does not respond, give her the words, “I need a fork Mom.”  Then act surprised, “Oh right right! I am so sorry.  Let me get you a fork.”  Try this activity throughout the day including homework time and bath time.  Set your child up for successful communication opportunities.

5.  When you are in the car, talk, talk, talk.  Driving the car is a wonderful time to promote language.  Constantly talk to your child.  Say things like, “Wow! Look it’s a white car! Look it’s a red car!  The sky is so blue today.  We are driving in the car.  I am sitting in the front seat.  You are sitting in the back seat.  It’s such a beautiful sunny day outside.  It sure is hot outside the car.  It is cold inside the car.”  You can wait between your comments to give your child a chance to react or respond.  Talking to your child and modeling language helps your child understand the functions of communication.

6.  Exaggerate shared attention experiences.  When you see an airplane in the sky and you look up at it, your child may not look up too.  She may not understand that when you are looking up at something, that indicates there may be something interesting up there.  So, try teaching her this skill.  Whenever you see something unusual or possibly exciting, bring it to her attention in an exaggerated manner.  For example, if you are outside playing and there are some bright orange leaves, make a huge deal out of it!  Point to the leaves and excitedly say, “Oh how beautiful!!! Look at those bright orange leaves.”  Encourage her to look at the same object that you are looking at.  Try pointing to the object, but if she doesn’t look in that direction, you may need to move her head and body to face that way.  Shared attention is a huge part of communication and teaching this skill can really benefit her in the long run.

7.  Sit at the dinner table for mealtimes.  Eating together as a family creates numerous communication opportunities.  Your child can observe the rules that are involved in reciprocal communication by observing conversations.  In addition, she has more opportunities to answer questions and to learn how to ask questions.

8.  Play with your child.  Sit down on the floor with her and model appropriate play and communication skills.  Say phrases like, “My turn. Your turn.  I don’t want that.  No thank you.  Yes, please. I want a turn.  I won!  Oh well, maybe next time.”  Teach sharing and turn taking skills during this time.  By participating in activities and games that she is interested in, you are more likely to get a response.  Also try, imitating some of her actions to get into her world.  Then encourage her to imitate you.

9.  Get your child’s attention before you talk to her.  Say her name and make sure she understands that you are talking to her.  You may have to take her by the hands to let her know you are speaking to her.  If you are speaking to another person in front of her, be sure to state the other person’s name and make it clear to whom you are speaking. I have observed many students in classrooms get upset because the teacher was disciplining a child and the other students thought the teacher was speaking to them!  A breakdown in communication can trigger a meltdown.

10.  Teach introductions to random comments.  If your child is verbal and likes to approach you with stories in mid-thought, teach her to make introductions to her comments.  For example, if she says, “Jessica sang a song and she wore a dress.”  You may look at your child thinking, “I have no idea what you are talking about.”  However, a better strategy would be to teach her that all she needs to say is, “Hey Mom! May I tell you about what I saw on American Idol last night?”  That one introductory sentence makes a huge difference, and turns a random vocalized thought into an appropriate conversation starter.

If you liked this article and found this information helpful, be sure to set up your free “Get Acquainted Call” with Jennifer Lingle, M.Ed., Director of Autism Consulting and Training, Inc.  Click here to set up our call.