Saturday, December 30, 2017

8 Things You Need to Know When Working with a Student Who has Autism { #3 }

 I hope you are all coming down off of a beautiful holiday season! As you can imagine, it's been a hectic time of year, and the festivities and Christmas prep have kept me away from blogging. In fact, during the past couple of months it has felt like I'm holding my entire life together with a bobbie pin. Anyone else? 

The year is almost over. I can't even believe it!! Where did it go? 
 Well, as we close 2017, I'm squeezing in another part of this series... 8 things you need to know when working with a child who has autism.  What's the third thing I think you should know? 

Here it is - #3! 

At the heart of it, autism is a condition that comes with inherent anxiety. Also, because children with ASD don't process all parts of their environment the same as their typical peers, they lack reference points and schemas (cognitive framework) that help organize and interpret information. 

Most kids would think, "hmmm, who are these people? What are they doing? Oh, that lady is showing them a book. She's reading it to them, and they're listening. I want to do that. How can I go do that? I wanna do that, too. Let me sit right here; there's a spot." 

For the most part, the can pick out the most important thing that is happening and join the action. They join their peers. 

Kids with autism usually do not. They have difficulty weeding through the vast amount of visual information in front of them, and they are not naturally drawn to the individuals in the room. They may tune in to the colorful rectangles on the bulletin board border or be attracted to an object on a shelf, but their lack of reference points and inherent anxiety make it terribly difficult for them to interpret everything in the room and formulate a plan of action. At the same time, their struggles to "read" the children and teacher, make is difficult to make social inferences. I imagine it must feel a little like being dropped onto a foreign land where you can't understand the language and aren't familiar with how things "operate."

If you've worked in the schools, you've seen this unfold on the first day of school when a child with ASD is faced with a new teacher and/or classroom. WHOA. Often he or she zones in to 1 or 2 objects in the room and sticks to them, leaving all the adults in the room wondering why he or she won't engage or join the class. Or the child just runs - in attempt to flee this confusing foreign land. 
You need to know that....
So here are some things to think about: 

1) Being with others is anxiety provoking, and they need time (and lots of reinforcment) to build their tolerance to us. 
2) Because of that, we need to approach slowly and softly in our therapy. 
3) If JUST BEING AROUND US is hard, just think at how much we should reinforce them. 
4) They need visuals and adult models to build refernence points. 
I bet the first thing you thought of was "stimming."  Ding, ding, ding! 
Those repetitive motor movements that children with autism so often do, are a sign that they are disregulated or in sensory overload. They often "stim" as an attempt to "hold it together." Some children will also become physically aggressive, but of course, outward signs ot anxiety always vary from child to child. 

That's the question we should always be asking ourselves. 

All of these can reduce anxiety:

  • Sensory aids
  • Reducing sensory input
  • USE of a picture schedule (notice that "use" is emphasized? They cannot just exist; they have to actually be used.)
  • Timers (If a certain time is aversive to your student, try another kind. Find one that isn't.)
  • Reinforers and postiive reinforcemnt used with fidelty- be it a token economy of otherwise
  • Introducing/frontloading items/events/objects/people that the child will see later to mentally prepare the child for events
  • Using less language - In an anxious state, it's even more difficult to comprehend language.

I'm sure you can imagine all the things that INCREASE anxiety! There are too many to list!

The reason I think it's crucial that anyone working with a child with autism realizes that just "being around us is hard and intensifies anxiety" is because this awareness helps us to cut them some slack, for goodness sakes!

We have very high expectations of children these days (perhaps too high, in my humble opinion). and we need to be keenly aware that just being in the room is a major accomplishment for kids with ASD. We need to proceed gingerly and reinforce the heck out of their coping with things that are tough (like simply being with us).

Just like in the old story of the tortoise and the hare, slow and steady wins the race. Hardcore instruction and demands that intensify anxiety gets us no where.

Also, their noncompliance has nothing to do with you (the therapist, the teacher, the staff) and everything to do with the anxious state they are in just living with autism.

I hope to see you back here in 2018!
Happy New Year, y'all!


  1. What a great post! Understanding anxiety in our kids on the spectrum goes a long way in helping them learn and grow with us.

  2. This is such an insightful post. Your points seem like common sense; I think as SLPs we forget that not everyone realizes what children with autism need.

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