I recently came across a Facebook page entitled, "Autism Discussion Group". This page was developed by Bill Nason, MS LLP to discuss tools that help children on the autism spectrum feel safe, accepted, and competent. Although each child is different, with their unique strengths and challenges, there are some common strategies that can strengthen the social, emotional, and cognitive security for most children on the spectrum. Come learn, share, and support.
I found the page to have some helpful strategies and information that I believe school staff and families will find helpful. If you are on Facebook, I encourage to visit the page and spend some time checking out all of Bill's great ideas. In particular, related to past posts we have made regarding movement issues and accommodations, I offer you Bill's thoughts and ideas regarding what to do when students with whom you support get stuck:
HELP ME I'M STUCK
(Autism Discussion Page)
Does your child get stuck in an action that
they seem to have difficulty shifting from? This might be a repetitive
behavior, vocal noise, activity, or thought. With this problem, the
child will initiate the behavior, task, or thought and seem to have
difficulty ending it. They continue on and on in a fixated pattern.
Our ability to shift from one activity or thought to another
is an executive function of frontal cortex of our brain. It allows us
to initiate, implement, and stop a behavior fluidly with little
difficulty. For many children on the spectrum, these functions are
weak. Once a behavior gets started, and especially if it is a
repetitive pattern that feels good, the child has difficulty shifting
gears and moving on to the next expectation. Like a person who doesn’t
know how to end a conversation, so he goes on and on and on.
Sometimes these behaviors are labeled as fixations, compulsive behavior,
stereotypic behavior, or perseverations. All of these
behaviors/thoughts have in common the difficulty ending the chain once
it gets going. Often I see parents and teachers get upset and simply
demand the child to stop, only to have the child blow up in an emotional
rage. I think we must recognize that many times these behavior
patterns are difficult for the child to stop, and they need to
“transition” out of them. I have found the following successful in
different situations and different children:
1. Some kids
simply need a warning of when the behavior needs to stop. They are
really not stuck, just hyper-focused and thoroughly into what they are
doing. These child often respond to reminding sequence. Parents give 5
minutes, 3 minutes, and one minute reminders that the activity will end
and what will occur next. These same children do well with clearly
defined start and stop times to the activity. We often use visual
timers to clearly define the beginning and ending of the behavior.
These children often respond well to a picture schedule that lets them
see what is coming up next, so shifting gears is easier.
2.
For behaviors that are compulsive or perseverative, another technique
can work well. First include yourself briefly in what the child is
doing, without asking him to stop or directing him to do something else.
Talk about what he is doing and turn it into a we-do. This draws the
child’s attention from the task/behavior and onto you, before directing
it on to something else. For example, I had a child who would engage in
hand washing motions under the running water. It appeared he enjoyed
the sensory stimulation, but would get stuck in the action and have
difficulty ending the activity. He would get upset when the parent came
in and told him to stop. Instead, we first eased the transition by the
parent going in and including themselves in rubbing their hands
together under the water, and talking about how good it feels. Then
once they got the child attention shifted on them, they talked about
what to do next, would turn the faucet off and move on. This “including
themselves” in the action, interrupted the perseverative response and
allowed the child to switch gears.
3. In addition to the
above, you can also try creating a concrete ending to the sequence. In
the example above, you might include yourself in the action first, then
count to ten and turn the water off. I do this a lot with behaviors
that include repetitive trials of the same behavior. I will say ok, we
will do it five more times than stop. Together we count to five, and
then move on. By giving them a concrete stopping point it allows their
brain to transition.
4. Often I find that the person might
need gentle touch to shift the brain’s focus. So, I will quietly say
something to them, and gently touch them on the arm as I include myself
in what they are doing. This tactile stimulation seems to jar them from
what they are stuck on. This seems to break the neurological feedback
loop that allows them to shift.
5. Some getting “stuck” is
because the child starts an activity that doesn’t have a clear stopping
point. They simply do not know when the task is completed, or when the
work is good enough. These children will get anxious because they do
not know when something is good enough, or completed. For these
children we usually preview all activity ahead of time and let them
concretely know when the task is completed.
6. For the hard
to “shift” children, we will often follow the behavior that they
frequently get “stuck” in with a favorite activity, so it is more
motivating to shift (with one of the above strategies). This way we can
more easily gain their cooperation in shifting from this perseverative
pattern to a another activity that they enjoy.
Between the
children’s tendency to hyper-focus attention on something of interest,
and have difficulty ending one activity and moving on to the next, it
is important to understand that part of this perseveration is a problem
in brain functioning. Getting stuck in a neurological feedback loop
often needs gentle help in transitioning. However, try and ease the
transition, rather than directing the child to stop.
