How to Make Change Less Scary for Children With Autism

Takeaway: To make change less scary for your child, get her used to following a clearly-outlined visual schedule, and then gradually introduce ‘change cards’ to challenge her need for predictability. If done right, you’ll be able to systematically desensitise her to many types of change and teach her to use coping strategies for any anxiety she feels.

Children with autism have to deal with a lot of extra anxiety.

Most children get anxious from time to time, but children with autism have much higher anxiety levels and get anxious more often. Some studies even suggest that since their anxiety episodes are so intense and frequent, many of them could technically be diagnosed as having an anxiety disorder. And worse still, since they struggle to communicate their distress, they’re rarely able to ask for help. So the anxiety intensifies, leading to other issues like social phobias, avoidance behaviours, meltdowns, and a greater need to control their environment.

Often, these anxiety episodes are triggered by changes to a child’s daily routine.

Children with autism love predictable routines because it helps them feel more in control. Unfortunately, daily life is often unpredictable enough to trigger their anxiety episodes. They have to deal with changes in location (e.g., going from home to school), changes in the people they’re with (e.g., meeting a visiting house guest), changes in activity (e.g., switching from playtime to study time), and more. Plus, they have to adapt to larger, one-off changes like transitioning from primary to secondary school or welcoming a new baby to the family.

To tackle the discomfort of change, we first need to create the comfort of a daily schedule.

Your child can learn to cope with a lot of anxiety, but she first needs a safe space to process her overwhelm. And this means helping her design a predictable, calming daily schedule. You’d start by listing time slots in 1-hour increments (e.g., 6 AM to 7 AM, 7 AM to 8 AM, etc.) and pencilling in anchor events like meals, play, and study. You’d then build the rest of her day (TV time, room-cleaning time, etc.) around these anchors. The key is to be specific enough for her to know exactly what, when, and where the next activity will be. So, the instruction to ‘eat breakfast’ is less ideal than ‘eat cornflakes at 7 AM out of my favourite blue bowl.’ Better still, make the whole thing visual by taking a photo of her eating cornflakes and sticking it in the schedule’s 7 AM slot.

Next, start priming your child before each transition in the schedule.

Even with her day laid out, your child might struggle to transition from one activity to another. Here’s where priming her for the change will help. Right before the next transition, remind her about what’s coming up, using the same ‘transition script’ if possible. So, after she’s done with her cornflakes, you might say, ‘We’re going to school now, and you’ll be able to sit in your chair and learn about <fill in her favourite subject/topic>.’ By sticking to the same script each morning, you’re transforming this potentially-unsettling transition into just another regular, predictable part of her routine.

For particularly difficult transitions, try expanding one-line scripts into longer ‘social stories.’

Transition scripts work because they’re a simplified version of longer ‘social stories’ – which are a communication-focused social learning tool. For example, if your child often has meltdowns right before school, you could create a social story to prepare her for the transition. It might read (from her point of view): ‘We walk to school every morning. Sometimes I don’t like this and get upset. But staying calm is good. So, if I get upset, I can listen to my music and become calm again.’ Notice what we’re doing here. First, we describe basic facts (‘We walk to school every morning’). Then, we explore deeper emotions (‘I get upset’). Next, we affirm desirable behaviour (‘Staying calm is good’). And finally, we re-establish a sense of control (‘If I get upset, I can listen to music and become calm again’). To transform this into a fun, creative project, have your child help write/illustrate meaningful stories for you to read out loud daily. And after she’s fully internalised one story, you can work on others – preparing her for events like school trips, birthday parties, shop visits, nature walks, and more.

Once we have a predictable routine with smooth transitions, we can introduce the concept of change using ‘change cards.’

Visual schedules help calm your child by rooting her in the known. But now we gradually need to introduce her to the unknown. And we’ll do this using ‘change cards’ – i.e., mystery cards with visually striking images (e.g., a big, colourful question mark) that we slip into her daily schedule. The cards represent a surprise/unknown activity that your child will enjoy, but without any clues as to what it will be. So she’ll have to process this unknown (and therefore, unsettling) task, but with the reassurance of a specific start and end time.

Change cards systematically and gradually desensitise your child to the unknown.

By replacing boring, planned activities (e.g., ‘clean your room’) with surprise, fun ones (e.g., ‘play outside’), you’re gradually immunising your child to the idea of change. Begin with a single change card each week and systematically build up to one or more a day, if possible. And start by replacing boring activities with fun ones before swapping fun activities for not-so-fun obligations – e.g., replace ‘watch TV’ with ‘finish maths homework.’

Crucially, you’ll teach your child new coping and self-soothing strategies to deal with her anxieties.

If you introduce change cards wisely, the process will be so gradual that your child will never feel too overwhelmed. But part of the process is to teach her how to mindfully monitor her emotions and self-soothe by using fidget toys, weighted blankets, noise-cancelling headphones, deep breathing, stimming, etc. Equally important, you’ll want to give her a sense of control by allowing her to choose aspects of her ‘change’ activities. For instance, if you’re replacing study time with TV time, let her choose what TV show she’ll watch. And if she has language difficulties, you could use a visual ‘choice board’ to present her with thumbnails/images of a few TV shows to choose from. Lastly, consider using a timer to help her track when the next activity transition will happen.

We’ve covered a few general strategies in this post, but many children often need more targeted attention.

An experienced specialist can tailor the strategies we’ve discussed to your child’s unique needs. So do contact us for suggestions, solutions, and a custom support plan. The Ed Psych Practice offers face-to-face and online assessments, consultation, advice, and problem-solving strategies for parents, nurseries, schools, and universities in London. We have psychologists, paediatricians, and therapists who can help assess your child and offer guidance and support. To consult with us or set up an appointment:

• Phone: +44 (0) 78 3344 7356
• Email: Office@TheEdPsych.com

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