Jessica Kingsley Publishers

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Homespun Remedies

Strategies in the Home and Community for Children with Autism Spectrum and Other Disorders

Dion E. Betts and Nancy J. Patrick

Paperback: £14.99 / $24.95

2006, royal, 160pp
ISBN: 978-1-84310-813-9, BIC 2: VFJD MMZ

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1: Home Life

Parents and caregivers know that home life is not typical when you have a child with an autism spectrum disorder. What is taken for granted for most individuals, is often difficult for these children - it is not that these children are trying to act badly or that they do not care about what they do.

The disorder prevents a child from understanding and remembering what we consider simple routines. For example, even going from TV watching to dinnertime can be difficult. It is easy for parents and caregivers to become frustrated. Often this frustration is borne out of the belief that the child "should" be following directions better or that the child is willfully disobeying. Children with autism spectrum disorders are not perfect and can be disobedient just like all other children. Moreover, it is typically not an issue of having the intelligence to do what they are asked. Sensory system, language processing, and other physical issues prevent such children from fitting in easily within the routines of the home and community.

Individuals with typical nervous systems follow signals provided by the environment that children with autism spectrum disorders often do not see or understand. For example, when a parent or caregiver is working in the kitchen to prepare a meal, typically a child will know that the signal will soon be coming that dinner is ready. During this time, the child will prepare him or herself internally for the transition from playtime to dinner. They know they need to wait and to begin to have closure on their play. When the call to dinner that the child has anticipated finally comes, he or she is ready for this transition. Many children with autism spectrum disorders are not able to detect nonverbal environmental signals which indicate a change. For example, they may not associate working in the kitchen with a meal soon to come or getting themselves ready for dinner.

While this chapter does not include every possible difficulty that may be experienced in the home, it does list the most frequently experienced problems as reported by parents. The importance of structuring a child's surroundings is the key to their success in any situation. While rewards and discipline can be used with typical children with a great deal of success, for children with autism spectrum disorders these methods fall short. This is because children with autism spectrum disorders are often responding to internal and external stimuli that are quite overwhelming for them. Again, it is not that they are willfully trying not to follow what they are supposed to do. It is that their surroundings overwhelm them. This is why often the best thing that parents and caregivers can do is to make accommodations to a child's environment.

Babysitters

What happened?

Mrs. Wilson, Brad's mom, did a good job by providing a schedule for the babysitter to follow. She has learned from her own experiences that Brad is a child who requires a great deal of predictability and structure in his life, particularly when there is a major change in routine, as in the case of a new babysitter. Mrs. Wilson and the babysitter, Sherry, were also wise in planning a short two-hour initial session to enhance the likelihood of a successful experience.

It was a good idea that the babysitter came early to get acclimated to the schedule and supplies in the home. However, the babysitter did not understand the reasons that Brad required such a strict regimen. This kept her from understanding that it was in the best interest of the child that she follow the schedule provided to her.

She thought that the evening was going well and that a minor change in the menu would be for the better. After all, Brad is a handsome, "normal" looking kid. At some level, the babysitter most likely thought that schedule was just a guideline rather than an agreement that the child was following and depending upon for predictability. However, the babysitter did not understand the nature of the disability, and, as a result, did not think that she needed to follow such a strict regimen. The babysitter may have even thought that the mother was overprotective when she handed her the schedule.

Homespun remedies

Mrs. Wilson knew that in the past she had experienced the benefit of using schedules with Brad. She understood the underlying benefit to her son after having observed him for many years. She discovered that the missing piece in this scenario was that she needed to take more time training Sherry in understanding the underlying deficits that required the use of schedules with Brad.

The babysitter needed to understand that the schedule was a tool used with Brad that provided him with information about events as they unfold. At this same time, the schedule creates a predictable environment. Increased understanding and predictability reduces stress and leads to better self-regulation. The babysitter also needed to know that because of Brad's significant language delays he did not always know what was going on and could not always predict what was going to happen.

Mrs. Wilson recognized that she needed to describe Brad's disability in greater detail. She especially needed to explain the importance of taking the perspective of an individual with autism. She needed to explain how the disability is in many ways a "hidden" disability. Brad looks like every other child, but thinks and responds differently to his world.

Mrs. Wilson provided a schedule for the babysitter, but did not provide a visual schedule for Brad to view. Such a schedule should be provided for the babysitter. The babysitter can point to each step in the schedule as it comes up. Again, children with autism spectrum disorders need such predictability to help them regulate themselves.

Many parents that we talked to suggest that a schedule for a babysitter is used. A sample schedule for a babysitter may look like this:

Choice playtime:
Use choice board with selection of three preferred activities (Chapter 6 has information regarding developing choice boards).
Eat dinner:
Hamburger, French fries and soda with colored straw (of child's choice).
Clean-up:
- Take plate, cup and utensils to the counter.
- Put napkin in wastebasket.
- Use a soft cloth kitchen towel with warm water to wipe child's mouth and hands.
Choice video:
Use choice board with selection of three preferred video programs.
Bedtime routine:
Get pajamas.
Dress in pajamas.
- Potty.
- Brush teeth - review micro schedule on mirror.
- Wash face - review micro schedule on mirror.
Choice settle down:
Use choice board with selection of three preferred settling activities.
Choice bedtime:
Read a short book to him of his choice from the book choice board.