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How Can I Prepare My Child with Autism for Transitions?

Advice on Transitions from Readers of Autism.About.Com

From , former About.com Guide

Updated May 13, 2010

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A grandmother visiting the About.com Autism Forum has a ten-year-old grandson with autism. She asks the following question:
    My grandson has severe autism - no language, some drastic behavioural patterns, toilet training "accidents" and other factors which make life very difficult for all our family. However, we all love him dearly and just want the absolute best for him.

    His latest "top of the hit parade" behaviour is a complete meltdown (screaming, hitting himself, waving his arms and legs quite violently around) when he has to leave somewhere he obviously likes, or when people he likes leave his home. We have tried to show him the day's procedure with pictures, tried to distract him with food - it is of no use whatsoever to try to be firm with him, as this just leads to more self hitting on his part - anyone have any other strategies we could try to deflect or stop this behaviour, please? We also tried to get him to use his portable DVD player, but this was of no use.

    It means that any visits away or visitors to our daughter's home result in this behaviour, which totally ruins the day. Please! Please! Any help?

When it comes to handling difficult situations, there's no one who knows more than a parent who has been there, done that, and found answers that work. Here are some About.com readers' responses.

Caroline Suggests a Countdown to Transition

If meltdowns happen when needing to leave a favorite place, try a countdown schedule. It could be “In 5 minutes we are leaving,” and then remind at 2 minutes, then 1, and followed by “It’s time to go now,” or a number system where it’s the same idea, but he sees the numbers 1,2,3,4,5 for each minute, then as a countdown, he has to take them each and put them in a “Finished” bucket -- ideally Velcro them onto a small piece of card or laminated paper, then do the countdown. When it’s time to go, it’s time to go.

Social stories may also help. I wrote one for my son, outlining where we were going, what we would do when we got there (even if he knew because it was a favorite place), and what the expectations were when it was time to leave. I wrote at the bottom that “after countdown is finished, we leave. We walk quietly out to the car. No screaming, crying, or throwing a fit.”

You didn’t mention your grandsons’ method or level of communication, but perhaps this needs to increase if it is low. Acknowledge that you hear him, that he is angry (perhaps learn angry in sign language so he can see it as well as hear the word) and he’s allowed to be angry…but when he behaves like that, he loses out on the next time. If one week apart is too long for the promise of a favorite activity, then make the time he has to wait to do the favored thing again in his comfortable time frame. To help him understand, put a picture on the calendar of the favorite activity and count down the days with him.

Sandy Suggests Sticking with One Routine

The best advice I can give is to pick a routine and structure when this occurs, and even if it does not appear to be working, stick to it. Many kids rely on structure and consistency even during melt downs and maybe more so at that time.

Cathy Suggests Searching for the Trigger Problem

Be a detective. From your description, it appears that the primary trigger for your grandson’s meltdowns is change. Specifically, he obviously doesn’t like change of place – either for himself or for other people. Scout out other factors that contribute to his meltdowns. Here are just a few examples:
  • (A) In most families there is a lot of commotion when getting ready to head out the door. Does that long preparation – getting coats, saying goodbye, lots of people bustling around, talking, etc. – build up his stress?
  • (B) You write that your grandson melts down “when people he likes leave his home.” What would happen if people just slipped out the back door without fanfare?
  • (C) Sometimes a youngster is late entering into the phase of emotional turmoil of the “terrible twos.” Maybe your grandson is just now at that developmental stage. A ten-year-old is just much more furious and destructive than a two-year-old because of size and strength.
  • (D) Some of my friends with autism simply have extreme episodes out of the blue – somewhat like an emotional seizure.
We’ve been able to trace some to PMS symptoms of pre-teen and teen girls, but the causes of other storms are more elusive. A plan of action is most effective if you can discover the triggers because it allows us to be proactive rather than just reacting when we see a meltdown beginning. There are many other factors that can escalate a situation, so look carefully at all that is happening before, during, and after the meltdown.

Robin Recommends Sharing a Plan for the Day

My son is twelve and has high functioning autism. He is verbal but still has tantrums and melt downs. Transitions are really hard for him. One thing that has helped him is to give him a run down of the day ahead of time to prepare him. Also giving him the ten, five, one minute warning helps too. Most of all, lots of patience and a calm voice.

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