The Importance of Routines and Schedules in an Autistic Individuals Life

Busy people and Autism

If you have been raising an Autistic individual for a while you may already know that schedules and routines are pretty much key to their development. Truthfully, routines play an important role in the lives of people with Autism. In fact, one of the earliest signs of Autism can be a love of ritual, consistency, predictability and routine. It boils down to simple things that “normal” people do every day being intensified to the max for a person with Autism. The everyday events that most people view as “normal” can be an overwhelming combination of frightening crowds, intimidating sounds and overbearing lights for people with Autism. Routines and schedules help to create stability and order.

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Routines and Schedules are two different things. A routine can be damaging, a schedule cannot. A schedule is a way to help deal with their everyday events and routines more effectively. Routines are things that your child does ritualistically and somewhat obsessively at times. Some routines can be harmless, but others can cause serious inconvenience. Suppose, for instance, as one website suggested, that your son or daughter will only use one toilet at school: what happens the day it goes out of order? Or suppose they’ll only eat breakfast out of a particular bowl: if it breaks or you forgot to wash it the previous night, come morning there’s going to be trouble. A degree of regularity in life is no bad thing, but when a child can’t cope with changes in that regularity, life starts to get difficult.

For a child with Autism, the world can feel like an unpredictable place – and since children with Autism tend to be anxious, unpredictable equals frightening. So, what’s the natural solution? To try to make things as predictable as possible: to try to control the environment to make sure that no new situations come along that make everything frightening again. To do this you create a schedule for them.

There’s no denying that the need for routine can get inconvenient when it applies to a lot of things.

Per Ambitious about Autism, common areas where fear of the unknown kicks in and routines and schedules may come into play include:

“-New food or drinks: Food issues are a big one and, if extreme enough, can cause worries about malnutrition.
-Leaving or entering the house: You may have to perform a lot of rituals to get your son or daughter to cooperate, which isn’t easy if you’re in a hurry.
-New people: Visitors to the house or a new person in a familiar place (such as a supply teacher) can cause a lot of anxiety.
-Going to new places: Some of these, like hospital appointments, can’t be avoided.
-Arranging the familiar environment: If your son or daughter has decided that the living room door should be closed at all times or that the soap belongs on the left-hand side of the sink, even a small change can be a big deal. (This is a huge deal in my family)
-Doing ordinary routines in a particular way: It may not seem important to you whether your son or daughter flushes the loo before or after they wash their hands, but it can seem very important to them.
- ‘Transitioning:’ This is the technical term for switching between toys, activities or tasks: once your son or daughter has settled down to one thing, changing to another can be surprisingly hard.” Give them plenty of warnings of transition times in 5 to 10 minute increments.

It is important to note that making the schedules visible for the Autistic individual to see daily is key, as most Autistic individuals are visual learners. These visual queues help them to navigate through the day smoothly and with fewer meltdowns and bouts of overstimulation. I like to describe the overstimulation as if you were in a foreign country, on your own, without knowledge of the language being spoken to you and be expected to remain completely calm and cool. It would be next to impossible for the “normal” person not to panic. It’s the same way with overstimulation from not having a routine or visual schedule at home.
In my home I have several visual schedules of the day placed about. They starts from wake-up and walk him through every step of the day. Starting with breakfast and brushing his teeth, to break times and bath time. It is all on there and planned for him. We rarely deviate from this schedule as the predictability has a calming effect on my son. He loves the repetition every day.

Per Autism Spectrum Australia, “Individuals with Autism fortunately learn routines quickly and are naturally motivated to repeat them.” If the steps in a routine are presented with a clear beginning and end, as our family’s is, the total routine is often learned quickly and efficiently. Since people with Autism are naturally motivated to repeat routines, the completion of the schedule is reinforcing in itself. This includes “daily, weekly, monthly and annual routines, as well as structuring tasks as consistent routines.”

So, what are some Practical Strategies for implementing a routine in your home?

Per Autism-help.org, here are some 11 great pointers for setting up a routine:

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Set rules and use contracts: Set plenty of rules, children on the Autism spectrum tend to love clear logical rules. These rules can set time limits for routines, and the contexts they are allowed to happen. It can help to even write these down in a contract.

Shape the existing behavior: Look for ways to 'shape' the preoccupation into something constructive i.e. a fascination with butterflies can lead to discussions about biology and other insects. Children with Autism often don't see the 'big picture', so it always helps to try to broaden the narrow interest into a wider one and include it in your daily schedule!

Desensitization: Where sensory problems are involved, desensitization is a behavioral technique that can be useful when a child experiences anxiety or fear over a certain obsession or failing to do a set routine. The child is gradually exposed to the object or event that creates fear, but with plenty of positive reinforcement. Examples of this include free time, verbal praise or special food treats.

Reinforce desired behaviors: Reinforcement provides a response to a child's behavior that will most likely increase that behavior. It is “differential” because the level of reinforcement varies depending on the child's response. Difficult tasks may be reinforced heavily whereas easy tasks may be reinforced less heavily. We must systematically change our reinforcement so that the child eventually will respond appropriately under natural schedules of reinforcement with natural types of reinforcers (social). Reinforcement can be positive (verbal praise or a favorite activity) or negative (an emphatic 'no'). Positive reinforcement is an incentive given to a child who complies with some request for behavior change. The aim is to increase the chances the child will respond with the changed behavior. Positive reinforcement is given immediately after the desired behavior has occurred so that it will shape the child's future behavior.

Medications: While any concerned parent or doctor will try to avoid medications for children's behavior, it must be acknowledged that there are times where therapy does not work, and medication might. For example, a child diagnosed with Obsessive Compulsive Disorder may respond to medication in a way that creates far less stress for exhausted families. Always consult an experienced Autism specialist when considering the use of medication for children.” Medications can really help set a routine in place and help reinforce the proper behaviors from our children.

Use visual supports to explain what’s going to happen. Pictures of new places, written lists, ‘now and next’ boards, calendars: all make it easy to literally ‘see’ what’s going to happen. If you put the information where they can look at it and take it in in their own time, that may be a lot more comfortable for them.

If you’re going somewhere new, let them have a look at it in advance. Drive through the area, and if possible let them come in for a visit during a quiet period (for instance, visit a new school after hours so there aren’t so many other children making things overwhelming). That way they’ll have at least some idea what the ‘unknown’ will be, and hopefully they’ll start to accept that it won’t be anything terrible.

Use social stories. Tell the same story a few times in advance to help them do what’s often so difficult for them to do unaided: imaginatively rehearse what’s going to happen.

Prepare them for changes with a timer. A cheap stopwatch or an app can give them a nice clear countdown. If they know that, say, you’re going to leave the house when the timer goes off, they’ll have some time to get used to the idea. This works with break times and any transition throughout the day.

A good warning for you though, “a reliance on routine to provide certainty in the lives of people with Autism can potentially lead to their behavior becoming ritualistic and obsessively rigid.” This may be most evident during times of change or disturbance. We can’t always stick to a schedule every single day, things are going to come up. You are going to have be prepared for those situations. If this occurs it is possible to support Autistic people away from this behavior towards a more balanced approach to their regular routines and schedule.

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