“It takes a village to raise a child. It takes a child with autism to raise the consciousness of the village.” — Quote by Coach Elaine Hall.
Following a routine is important for people with autism spectrum disorder (ASD) just as visiting a family favorite restaurant is for others. It provides them with a sense of stability, harmony and a sense of well-being. They experience severe difficulty with changes in routine that they have got used to. This is exactly what would happen to Nigel Delemos of Texas. Accompanied by his caregiver, he would visit the neighborhood park for a walk, feed the ducks in the pond and enjoy the feel of sunshine on his body. If however, the weather was inclement on a particular day or the caregiver would be absent for any reason, the walk to the park would not happen. He would sulk, throw objects around the house and refuse to do anything. Walk to the park was his daily routine and he had difficulty with changes in routine to which he was accustomed.
Routine could mean eating, sleeping, activities done exactly the same way, every day. It can also mean minute details which others may overlook such as the placement of toys, the meal that they enjoy eating or even the layout of the objects such as bath towels in the washroom. Any deviation of the same is not easily accepted as you can see in the case of Nigel. A routine is a soothing balm for those with ASD as it helps them in dealing with anxiety and uncertainty. This is one of the issues that therapists face when engaging with autistic patients as part of the Applied Behavior Analysis therapy program (ABA). This resistance to breaking from a well-established routine is problematic when change is inevitable such as going to a new classroom, the arrival of a pet or the birth of a sibling.
Therapists are trained to deal with this as part of the program. Communication plays a role in helping people with ASD to adjust. Unexpected changes herald the problem. If the change is communicated well over time, then the reaction could be muted. This is the way Nigel’s family could have handled the meltdowns with regard to the park visits.
Introducing small changes into the routine one at a time and over a period is great and works. For example, if a child likes to eat first and then wear fresh clothes. You could try by getting them to wear socks first and then sit at the dining table for the meal. Reinforcement does wonder to aid each change in routine and transition. Reinforcing techniques can also be applied if the person is able to cope with an unexpected interruption or change for example if they are not able to go to a park, get a reservation at a favorite diner, the non-availability of a regular snack and so on.
Each unique person with ASD has their own abilities and challenges, and as we know no-one shoe fits all. Therefore, dealing with changes in routine is as varied.