Two powerful words that made all the difference!
"Don't touch that!"
"Wait, wait, wait!"
"Stop. It. Now."
Aren't these your favorite phrases? These were my go-to when my little lady would not, or could not, patiently wait or stop fixating on this or that. Many people have trouble waiting and managing anticipation, but ASD creates a new level of trouble that usually amounts to behaviors and distress.
Why is waiting so challenging?
Uncertainty is uncomfortable! There isn't always a clear reason to wait. Sometimes, we're waiting to be polite, for the right timing, to delay, and if the reason is abstract, it might not seem relevant to a child with ASD. When we have to wait because a car is coming, that is clear and reasonable, but when we're waiting because Suzy Creamcheese got there first, that is less obvious because social cues are often subtle and missed.
Combine missed social cues, sensory differences, and impaired executive function and you have a recipe for meltdowns.
So what can you do?
I recommend implementing the first/then strategy to temper this discomfort before the overwhelm occurs. This simple two-word structure has a big impact on a person who needs support managing the bigger picture. It works very basically like this, "First, we put on our shoes, then we'll go outside."
Too basic?
Ok. The idea is that stating the big idea in its entirety creates a diving board for those with ASD. For the average person, hearing, "We're going outside," creates a known string of events that will lead to an outcome. For many with ASD, all of that is just too much to process and overstimulating. Being overstimulated can look like stimming, running away, emotional outbursts, etc. So instead of a safe path forward, they're brought to a springboard they don't have the tools to manage, so they either jump headfirst or retreat.
Thinking specifically of my child. When I say we are going outside, she could be in the bathtub, mid-meal, or asleep, and she would just head for the door. Her mind doesn't work as mine does. She thinks literally and in the moment. For any event or activity that requires multiple steps for completion, I have to break it down consistently. Instead of, "We're going outside!" I must state, "We're going outside after lunch. So first finish the lunch on your plate and then take your plate to the sink... Now let's walk to the potty, wash your hands first, then turn off the light. Now let's find your jacket, then we'll put on your shoes! Now we can open the door, and go outside!"
This is wild, isn't it? It is not a natural way to communicate. I found narrating our lives exhausting when she was little. It seemed that I should be able to go over the steps to washing your hands half a dozen times at most, and she'd retain it. But no, that has not been the experience. It is almost like part of the process for her is the narration. However, at 9 years old now, she does have several scripts she can run on her own with simpler prompts. This is the reality of ASD for some people. Their mind is operating a different program that requires more frequent input. The interdependence of this relationship does mean that she will likely require life-long care, but I work hard to engage these scripts often and consistently to promote as much potential independence as possible for her.
When things are moving quickly and we are skipping steps, or ignoring the script altogether, I can count on overstimulation and a good amount of distress for my kiddo. Something about those two little words - first, then - gives her enough reassurance that we are safe and moving in some kind of order, and that is extremely important to her.
Step by step.
Breaking actions down into simpler step-by-step directions has a magical quality. To support my daughter, I've been pressured to reflect on how we move through the day, how to simplify it, and how to communicate it, but I truly appreciate the outcome. Transitions are notoriously challenging for people with ASD. Before I worked to narrate our day there were little hiccups I didn't understand. My daughter would be upset and anxious most of the time, and I did not know what was triggering her. Then, as I worked narration and first-then into our day, I saw her learn to relax. She had been experiencing micro-transitions all day long that I didn't consider. Once I was walking us through each task with 'first we're doing this, then we're doing this, now we're doing this, then we're doing that,' she was able to focus on the current task, prepare for the next one, and feel confident I'd be there to support her the whole time.
Does this sound exhausting? Yes, it can be. Lean into support where you can, and give yourself breaks so you can be present enough to achieve this, and remember, in time, many of these scripts you are teaching your child will run clearly enough in their mind that you won't need to spell it out too often.
Plus!
Since learning the magic of first-then in teaching my daughter, I've learned to apply the literal breakdown to any area of my life that feels daunting. If I have a pile of clutter to arrange, I sit back and say first I'll bag these, then I'll stack those. If I have a long-term goal I'm impatient to accomplish, first I'll manage this, then I'll manage that. Knowing the process and seeing it tackled one small step at a time relieves stress, helps me appreciate the small accomplishments, and keeps me connected to the way my child experiences life.
It can be easy to sweep her needs to the side in favor of moving swiftly or more efficiently, knowing the time it takes to assist her in processing everything, but that is not how I would prefer to raise her. Not only does investing now promote long-term independence, but it also saves us so many headaches and struggles with behaviors today. Do I sound like a broken record most days? Yes, but I'm her favorite tune.
Don't Forget to Find Support.
I recommend working with a therapist, maybe many, as in family psychology, Speech Pathology, OT, etc. to get your first-then process underway. There are so many little changes that make a huge difference for people with sensory processing differences. Managing how we speak has a measurable impact on our physical world and relationships. The more support you have and the more consistent you work on intentionally speaking to your loved one with ASD, the more profound you may find the impact to be.
First, consider how this article might impact your family, then give it a try!
The information provided in this blog post is for general informational purposes only. It is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your physician, therapist, or other qualified health providers with any questions you may have regarding a medical condition or the care of a child with Autism Spectrum Disorder (ASD). The views expressed in this post are based on personal experiences and research and do not necessarily reflect the opinions or policies of any medical or professional organization. Reliance on any information provided in this blog is solely at your own risk.
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