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Teaching Children to Understand Changes in Routines

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by Andy Bondy, PhD and Lori Frost, MS, CCC-SLP
Autism Asperger’s Digest
| May/June 2012

“Twelve-year-old Zena was terrific at using her daily picture schedule. She came into class each morning and immediately checked to see what her first activity was and whom she would be working with. However, her teacher found that there was one major problem.
If something did not go exactly as scheduled, Zena would get very upset and usually would not proceed with her schedule. While the teacher was happy that Zena had gained some independence, she was not pleased that Zena could not tolerate any change at all. It is one thing to try to perfectly control everything in the life of a three-year-old, but it is impossible to do so with a teenager. The teacher realized that no one had taught Zena to tolerate the changes that occur in all our lives”  (Bondy and Frost 2011, p. 122).

When working with children with autism spectrum disorder (ASD), it is often recommended that we try to keep everything highly structured and systematic because they don’t like to deal with change—they prefer to preserve sameness. The danger of this approach is that it can lead to substantially bigger problems when changes do occur, as they inevitably will! Should we wait until we see major behavior problems arise in reaction to change? We think that all children should be inoculated against inescapable variations in what life presents.

So, how can we teach individuals with ASD to tolerate change? By introducing it systematically rather than waiting for it to haphazardly take place. Rather than trying to create a fixed schedule suggesting we promise that everything we plan for will indeed occur, we introduce “surprise” lessons within the daily routine.

The first of such surprises should involve changes to an event or activity that are highly motivating. For example, the first surprise for Zena might be to go from doing a math lesson
to watching her favorite DVD or listening to her favorite music. To help make surprise part of a schedule, a special card or picture can be placed on a schedule or simply shown by the teacher. It is likely that Zena at first may not be pleased, but as the movie or music is played, she is likely to join in with the other students.

At this point all surprises should involve fun things to do. Of course, the teacher should also provide lots of praise for Zena’s new skill!

Over time, and as Zena reacts more calmly to these surprises, her teacher begins to introduce changes that are more neutral in outcome—perhaps Zena is surprised that she’ll work with Ms. Jones rather than with Ms. Hayes, or that English will be worked on before math, or she’ll be working on the table near the window rather than by the wall. During this time some surprises should be fun while others are simply “such a bother,” though not threatening or scary. It will be helpful to add some extra rewards each time the student tolerates changes—perhaps accumulating a series of stickers to be traded in for something special.

It is important to avoid using the same surprise at the same time in the schedule. If there is any ritual built into how this lesson is done, the very purpose of it will be undermined!

Finally, some of the changes should reflect the unpleasant parts of life that few of us truly enjoy: “Surprise! Your favorite toy doesn’t work.” “Another child is riding the only bicycle we have!” “There is no more popcorn.” “We must go to the dentist,” and so forth. Here, too, it will be important to provide other types of rewards for tolerating these changes as long as they are not giving in to the child’s dislike for the lesson. Along with these unfortunate surprises, the teacher must still remember to mix in some happy and neutral surprises—less surprise comes to mean “bad things are coming.” Over time a well-prepared teacher would never be without a handy Surprise! card so that when the office calls and says, “Sorry, your class can’t go to the gym—it flooded again!” you can simply turn to the class, take out the magic card and announce, “Surprise!”

These “schedule surprise” lessons should be combined with other strategies such as teaching “waiting” by gradually increasing the delay between the student requesting an item and actually receiving it. Another strategy that can be combined with a schedule involves teaching “later.” For example, although a child has requested playing on the swing, the teacher can add an icon of that on an existing schedule after completing several activities, thus implying “later” rather than “never.” A different strategy involves teaching children to make choices within a schedule. For example, the schedule can include a blue box or a green box. Each colored box is associated with a set of activities from which the child can select and put on the schedule. Perhaps blue activities involve literature and the child can choose to read a book or listen to an audio book. Green activities could involve a selection of art activities.

Each of the strategies in this article is designed to help individuals make choices and tolerate delays. Children and teens on the spectrum can learn to accept that while the world is not always completely predictable, there are many rewarding activities and events available.

BIO
Lori Frost, MS, CCC-SLP, is a speech/language pathologist and Andy Bondy, PhD, is a behavior analyst. They co-founded Pyramid Educational Consultants, Inc. They also co-authored the PECS Training Manual, 2nd ed.; A Picture’s Worth: PECS and Other Visual Communication Strategies in Autism, 2nd ed.; and Autism 24/7. Both travel extensively to train parents and professionals about PECS and the Pyramid Approach to Education.

Reference
Bondy, A., and L. Frost. 2011. A Picture’s Worth: PECS and Other Visual Communication Strategies in Autism, 2nd ed. Bethesda, MD: Woodbine House.

 

Copyright © Autism Asperger’s Digest. 2012. All Rights Reserved. Distribution via print is prohibited without written permission of publisher.


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