Adjusting the Physical Environment to Decrease Anxiety and Increase Compliance in Kids on the Spectrum

By Mark Hutten, M.A.
To make interventions that will decrease anxiety and increase compliance in children with High-Functioning Autism (HFA) and Asperger’s, parents need to create an environment in which their youngster feels comfortable and has an understanding of the events taking place around him or her. 

The environment needs to provide:
  • Structure
  • Routine
  • Predictability
  • Organization
  • Consistency
  • Logically explained rules
  • Clear rewards and consequences in response to these rules

When this is in place, the “special needs” youngster will begin to feel competent.

Here are the 4 steps to creating an optimal environment for young people on the autism spectrum:

1. Reinforcers (i.e., things that increase desired behavior) will need to be very individualized, because kids and teens with HFA and Asperger’s often don’t respond to typical reinforcers. Parents must be well aware of what their youngster views as a reward. Points to consider:
  • Reinforcers can cause difficulties if they are used too frequently. Not only will they lose their potency, but problems will arise over the giving - or not giving - of the reward.
  • Parents need to make sure their youngster is aware of how the reward/consequence system works. 
  • Natural consequences can be highly effective and will remove the "giving" or "denying" of the reward from parents (e.g., "If you finish your morning routine within 10 minutes, you will have time to play your favorite video game before school. If you take too long, you will not be able to play"). 
  • Incorporating the child’s obsessions into a reinforcement system is an appropriate way of offering a strong reinforcer and of also controlling access to the obsession. 
  • Favored activities should follow less favored or challenging activities.
 
2. At home and school, develop a daily routine so that the HFA or Asperger’s youngster knows what he or she is doing - and when. Points to consider:
  • Posting a schedule and reviewing it when the youngster becomes "stuck" can provide the necessary prompt to move on.
  • As parents review the schedule, they not only lessen anxiety, but also provide an opportunity to discuss appropriate responding. 
  • Compliance is not a struggle between the parent and child, but rather simply a matter of following the schedule. 
  • For teenagers, rather than using a written schedule, parents could use a desk calendar or day planner, which accomplishes the goal of providing a visual guide.
  • Parents should establish a routine for only a small portion of the day if they feel a day-long schedule would be too great a change for their youngster (e.g., create a schedule for an activity, such as going to the store, as an easier place to start). 
  • The child should view the schedule as a “guide.” A guide will serve to decrease anxiety, which in turn decreases behavior issues. 
  • When developing a schedule, number the items on it (e.g., 1, 2, 3 and so on), but avoid assigning times to each event or activity. It’s difficult to do things to the minute, and failure to do so can lead to further distress for the youngster.

3. The parent-child relationship with the HFA or Asperger’s youngster must be consistent in both word and action. Points to consider:
  • Interactions must be stable, allowing the youngster to anticipate how he or she will respond.
  • Make requests and follow through. Don't make second requests, and don't plead.
  • Make the rules and stick to them! Going "easy" on the child or giving him or her a "break" from the rules periodically will hinder the parent’s effectiveness.
  • Parents must be highly organized and pay attention to details as they create a structured environment for their youngster; however, they must also be able to remain flexible within this structure. By doing so, they will provide the structure their youngster needs to learn to be flexible as well.
  • The child must see the parent as a predictable person – a person in control, who is calm, and who keeps his/her word. 
  • The child must also see the parent as someone who can help him/her understand the world around him/her. 
  • And the child must view the parent as his or her helper or problem-solver. If the parent is only seen as a problem-causer, his or her effectiveness will be minimal.

4. The physical environment must be consistent. Points to consider:
  • Use the letters of the youngster's name placed on a chart to keep track of consequences. Throughout the day, if letters have been received, they can slowly be erased for positive responding. This provides a good visual response for appropriate behaviors, and parents can deliver this feedback (depending on the youngster's needs) every ten minutes, fifteen minutes, two hours, or whatever the parent thinks will work best.
  • Use charts with stickers to keep track of reward systems. 
  • Use consistent materials that are clearly marked and accessible (e.g., toys that are within easy reach and stored in or near the area they will be used).
  • Parents need to identify clear physical boundaries (e.g., a planned seating arrangement in school or a planned play area at home). 
  • In all locations, parents need to identify consistent areas where specific activities are completed (e.g., homework is always completed at the desk or kitchen table).
  • Expectations, rules, rewards, and consequences should be visually available – and must be clearly described to the youngster.
  • Certain designated areas/activities should have consistent behavioral expectations, which are explained to the youngster (e.g., "At my desk I do calm sitting; calm sitting is modeled and practiced”).

The creation of an effective environment will take time and will require parents to examine more details than they knew existed. The reward, however, will be the relief of watching the HFA or Asperger’s youngster leave his or her anxieties and problematic behaviors behind. Parents will see the child begin to really trust them and take chances he never thought he could. Parents will witness their child’s gradual and steady steps into a larger world. 

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