Tips to foster a happy holiday season for children with autism

Amid stay-at-home orders, remote learning and other changes caused by the COVID-19 pandemic, many families are faced with finding different ways to celebrate the holiday season than they’ve done in years past. The holiday season can still be a joyful time of the year. For families with a child who has autism spectrum disorder (ASD), following a few tips from the Thompson Autism Center at CHOC can help ensure everyone enjoys the festivities in their own way.

Activities

Holiday breaks often mean big changes in schedules and routines, which results in things becoming much less predictable. This can often result in the child being more anxious, less able to tolerate frustration, changes in eating/sleeping patterns, as well as impacting a variety of other triggers that may result in challenging behaviors.

To help your child, provide a visual schedule of each day, with start times and end times. Use visual timer apps, “First This Then This” schedules and personalized “social stories” to help prepare for activities. Try to maintain your child’s standard bedtime and mealtime routines.

Decorations

Instead of decorating your entire home all at once, decorate gradually. Look at pictures from previous years to help your child prepare for the change. Avoid overly bright or blinking decorations and strong scented candles. Create a holiday-free zone — such as your child’s room —for your child to come back and use as a “safe place” when necessary.

Gifts

Children with ASD can especially benefit from toys that involve social interaction, encourage turn-taking and build language skills. Give other family members a list of gifts your child might like.

Some children on the spectrum tend to repetitively talk about a gift that they want. To help set boundaries, offer your child three tokens that they can redeem each day to talk about the gift they want.

Opening gifts can be overwhelming for those on the autism spectrum. Video modeling is an evidence-based way to teach your child what to expect and how to behave. Take a video of family members opening presents, taking turns and saying, “Thank you,” and watch the video several times in advance. Also consider wrapping something familiar if your child does not enjoy opening new presents.

Traditions

Choose a tradition that is important for you and your family. Try not to get caught up with keeping old traditions. Create your own family traditions that follow COVID-19 safety precautions and are easy and fun for everyone, like decorating the house or tree using your child’s preferred items and participating in sensory-friendly programs.

“There are many ways to help your child cope with the hustle and bustle of the holiday season,” says Dr. Jina Jang, pediatric psychologist at the Thompson Autism Center at CHOC. “The most important thing to remember is that your child will enjoy the holidays in their own way, even if it’s different from how others enjoy them.”

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Tips for involving your child with ASD in the kitchen

Cooking as a family this Thanksgiving can be an enjoyable experience for all parents and children, including those with challenges related to autism spectrum disorder (ASD) such as food aversions or sensory issues. With a bit of planning, the experience can be fun, and help strengthen important skills. The Thompson Autism Center at CHOC offers these tips for involving children with ASD in the kitchen.

Safety first

Talk to your child about the importance of food safety and hygiene. Take the time to explain the danger of sharp knives and hot stoves. Demonstrate hand-washing and have your child practice good hand-washing side-by-side with you before handling any food.

Prepare in advance

Before the cooking begins, spend some time explaining new or unfamiliar words that may be used in the kitchen, like the ingredients and tools you’ll be using. Understanding the vocabulary can make the cooking experience more enjoyable for your child.

Avoid sensory overload

Cooking engages all the senses, which may be overwhelming for children with ASD. Try to avoid using noisy appliances or cooking with strong-smelling ingredients. Allow your child to wear food-safe gloves if they are uncomfortable touching foods with different textures. Try to expose your child to one new physical texture, such as gooey pie dough, and make a game of it.

Choose a favorite dish

Children with ASD are more likely to have food aversions. Involving your child in the kitchen is one step toward tasting new foods. Start by cooking something your child loves to eat. This could be as simple as a sandwich or pizza. If your child wants to eat what they are cooking, they are more likely to be engaged in the preparation.

Keep it simple

Try a recipe that is on the simpler side without a lot of steps. If visual supports are helpful for your child, — like they are for many children with ASD, — use pictures to show the steps of the recipe. Avoid too many activities with complex steps or motor tasks if those are challenging areas for your child. Chopping is a simple activity to try, and it’s a good way to improve fine motor skills. To help your child chop, put your hand over your child’s hand to help them maneuver items.

Complementary tasks

Give your child tasks that complement their strengths. For example, if your child is good at measuring, have them start by measuring ingredients. By mastering the easier skills and gaining confidence, accomplishing the harder task will be a much more enjoyable process.

“Cooking is a skill that can help a child with ASD gain independence as they get older,” says Dr. Tom Megerian, pediatric neurologist and medical director of the Thompson Autism Center. “It offers a chance for social interaction, lets children feel pride in their work and also may help broaden the range of foods they are willing to eat, as they taste their work. But even more, it is a way for you and your child to connect.”

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Students with ASD: How to adjust to a new routine this school year

By Megan Swinford, social worker, Thompson Autism Center at CHOC

Speak to any parent, and you’ll gain insight into the roller-coaster ride they’ve been on the past several months during the COVID-19 pandemic. Parents have adapted to having their children at home full-time while balancing their own work schedule, virtual learning, and have essentially transformed themselves into teachers.

Parents of children with autism spectrum disorder (ASD) or special needs have had even more barriers to overcome, since Applied Behavior Analysis (ABA) therapy that children usually receive with a therapist in their home has declined due to the pandemic. Now that the school year is upon us, how can you prepare your child with ASD to return to school and adjust to the new normal?

Regardless of which structure your child’s school district offers, your child’s success in school will depend on their ability to adapt and be flexible to an ever-changing environment. This is no simple request considering students with ASD may have challenges with flexibility. The good news is there are ways that parents and teachers can work together to help ease their student’s anxiety:

  • Talk to the teacher about your child’s triggers for anxiety. If your child had virtual learning at home last spring, you’ve probably become more aware of their frustrations and triggers. Triggers may range from sensory issues to unstructured time to virtual interfacing with classmates or their teacher. Whatever their triggers are, it will be key for you to communicate these with your child’s teacher.
  • Create social stories with help from a behavioral analyst and/or teacher. Before in-person learning begins, reach out to your child’s therapy providers and have them practice social stories such as hand-washing, personal space and mask-wearing. This will help normalize some of the new procedures that your child will be faced with this year and prepare them for a better outcome. As a parent, getting involved in these therapy sessions, and understanding how you can translate and practice these social stories at home, will also be helpful.
  • Prepare a schedule—as best as you can. If your child will attend in-person learning this fall, get a copy of your child’s schedule and see if you’re able to visit the classroom before school is in session to build familiarity. Ask their teacher what health precautions will be enforced so that you can practice them. If your child’s school will continue with remote learning, follow these tips: try to have a start/end time each day, incorporate physical breaks that are planned for both you and your child, and create visual schedules.
  • Award flexibility with lots of praise and rewards. Make sure to award or praise even the smallest progress with your child’s flexibility toward new situations. This will encourage your child to respond positively to changes they may not be able to control. Since children with ASD can struggle without a consistent and dependable routine, teaching and reinforcing flexibility will be a strong skillset to develop.
  • Practice flexibility and openness yourself. Try to be open to unexpected outcomes, as hard as that can be. This will help model behavior for your child to follow. Flexibility and openness will be key in the next year, as schools adjust to putting new protocols in place to safeguard their students.
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What to expect at the Thompson Autism Center during COVID-19

Changes due to COVID-19 can be stressful for everyone, but especially for children with autism spectrum disorder (ASD) and their families. Here are some tips from a CHOC psychologist on helping your child with autism understand and cope with COVID-19.

Some families may be worried about going to a healthcare facility or doctor’s office during the COVID-19 pandemic. But now, more than ever, it is important for children with ASD to stay on schedule with clinical appointments, to prevent or address physical and mental health problems.

The Thompson Autism Center at CHOC is taking extra steps to help patients continue to get the care they need safely and with minimized stress.

Safety precautions

The Thompson Autism Center has implemented the following precautions to ensure the safety and well-being of patients, families and staff and decrease the risk of spreading illness:

  • A week before, as well as the day before your appointment, you will receive a phone call from a Thompson Autism Center staff member who will ask a series of screening questions related to COVID-19 exposure. These questions may include, “Have you or anyone in your family been exposed to someone with COVID-19 in the past two weeks? Have you or anyone in your family, been sick with cough, fever, runny nose, shortness of breath or upper respiratory symptoms?
  • Please bring masks for you and your child and wear them for the duration of your time in the center.
  • We ask that only one parent or guardian accompany each patient to their appointment. A home health nurse may also attend if necessary.
  • All visitors, patients and staff are screened at the center’s front door every day, via temperature checks and questions about recent exposure and health status.
  • Additional cleaning and other protocols have been enacted to ensure safety.

To help patients cope with the changes at the center, videos are available for your child to watch when you arrive, covering topics such as how to wear a mask, how your temperature will be checked and what to expect during your visit.

We recommend that you practice wearing a mask with your child before your visit. Here are some tips from a CHOC psychologist on how to help children who are afraid of wearing masks. If you have concerns about your child and masks, please speak to their physician.

Telehealth for autism appointments

In order to minimize the number of patients and families in the Thompson Autism Center at any one time, telehealth appointments are now available for certain types of visits, such as medication checks, initial assessment appointments and other appointments as necessary. To make these appointments most beneficial for you and your child, we offer these recommendations:

  • We recommend that you use a camera-equipped desktop or laptop computer, tablet or touchpad device rather than a smartphone. This allows our providers to have a full view of your child and observe how they behave in their environment, which is a key part of autism therapy.
  • Sit in a room that can be limited to just you and your child, free from noises, distractions and other people coming in and out.
  • During the telehealth visit, we will likely spend part of the appointment without your child present, just as we do during your in-person appointment. It will be important to have a caregiver or activity available to occupy your child, allowing you to concentrate on the visit and be able to freely speak without worry of upsetting your child if you need to talk about topics that may be irritating or bothersome to them.

We appreciate your patience as we navigate the fluid environment created by COVID-19. As we implement changes, we assure you that we remain dedicated to our mission to provide your child medical, psychological and behavioral treatment as well as support for your family.

This article was updated on June 23, 2020.

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How to help children with autism understand COVID-19

With schools and many businesses closed amid the COVID-19 pandemic, parents and kids are spending more time at home — and away from others — to help stop the spread of the virus. Adjusting to a new routine is stressful for parents and kids alike — but especially for children with autism who have trouble with change.

How can you help your child with autism understand what’s going on and what to expect from day-to-day? Pediatric psychologist Dr. Jina Jang offers tips for parents on helping their child adjust during this uncertain time.

What should I tell my child about coronavirus?

Kids with autism may not know what is going on, or they might not be able to express their fears and frustrations.

So it’s important to talk to your child about coronavirus in a way that’s simple to understand. Be clear, direct and honest. For example, “Coronavirus is a germ. It can make people very sick. We have to stay away from others right now to stay healthy.”

Go over important rules, and help your child to:

  • Wash hands well, for at least 20 seconds, and was them often. Here’s a pediatrician’s guide to proper hand-washing.
  • Try not to touch their nose, mouth, and eyes. Practice social distancing, keeping at least 6 feet away from other people. Wear a mask in public places.

Give your child space and time for questions, but don’t offer more detail than it takes to address their questions. For example, if your child asks about people who are sick, answer the question. But don’t bring up the topic if it doesn’t come up.

How can I help my child with autism understand COVID-19?

Kids with autism may need extra support to understand what’s going on around them, and what’s expected of them in some situations.

Social stories are stories that teach kids what happens in some situations and explain what kids should do in those situations. Several social stories about COVID-19 have been developed; reading the stories to or with kids may help them better understand COVID-19 and their feedings and offer assurance.

Visual supports may be helpful to break down the steps of the new “rules” around specific behaviors:

  • greeting people (e.g., no more handshakes, high fives)
  • washing hands often
  • social distancing
  • distance learning
  • new routines at home

You know how your child learns best, so use learning methods that have worked in the past.

How can I help my child adjust to changes brought on by COVID-19?

Routines are comforting for all kids, but especially for kids with autism, so do your best to keep as many of your normal routines as you can. Stick to regular bed and wake-up times, meal and snack times, screen time, chores and other household routines. But build in new routines to include schoolwork, breaks and exercise.

When possible, help your child take control by giving a couple of choices. For example, you could let your child choose what to eat for lunch. When doing schoolwork, you can ask what your child would like to do next.

Visual schedules and to-do lists can help kids know what to expect, while timers and 2-minute warnings can help with transitions.

Having a set routine and clear expectations will help lower the anxiety that can happen when things change.

Here’s more tips for establishing structure and routine while kids are home during COVID-19.

How can I help my child stay calm?

Kids with autism who feel frustrated, worried, or scared may have more repetitive behaviors (like hand flapping or rocking), tantrums, and other challenging behaviors.

Find ways for your child to express feelings. To help kids work through strong emotions, try:

  • talking together
  • doing crafts
  • writing
  • playing or acting out fears
  • for kids who are nonverbal, using augmented (or alternative) communication devices

Parents can also try calming activities, such as deep breathing, music, or watching a favorite video throughout the day. Exercise also can help ease anxious feelings.

While caring for your child, be sure that you take breaks and recharge too. Here’s a pediatrician’s advice for how parents can deal with stress during COVID-19.

Resources for parents with autism

Your child’s healthcare provider, teacher, or behavior or learning specialist can offer more tips to help your child during this time.

Talk to your provider if you notice changes in your child’s sleeping or eating habits, or if your child seems more worried or upset than usual. These may be signs of anxiety or depression.

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