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

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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Using Key Words and Phrases to Teach New Behaviors to Kids on the Autism Spectrum

When using words and phrases to teach new behaviors to your child with High-Functioning Autism, it will be crucial to develop and write them down on a poster board or white board. 
 
These words and phrases will be used when introducing or generalizing new behaviors to your child. By making them visual, you guarantee both greater understanding and usage of them.

Strange phrases or catchy sayings are often attractive and easy to remember, but actually using the words and phrases - not simply writing them down – is what makes them effective. Also, they should be developed by you AND your youngster, which will increase the likelihood that they will be remembered.

The steps to creating a list of key words and phrases:
  1. Choose the area you want to work on with your youngster.
  2. Select (or have your youngster select) a word or phrase to be used as a quick reminder for appropriate responding. 
  3. Teach your child to use the key words and/or phrases as needed. With consistent use, they will convey the concept and what appropriate responding will look like. This will allow your youngster to generalize a skill more easily. When the phrase is used in a new situation, he or she will know what to do, because the phrase corresponds to the new behavior. 
  4. After one key word or phrase has been mastered, add others as needed.

 
Below is a sample list of words and phrases that other parents have found to be effective. It would be daunting to try and teach your child all of these. Thus, simply pick two or three to start with, and then branch out from there over the course of several weeks or months.
  • Use your words (i.e., controlling yourself by using words when you are upset or frustrated, rather than responding with a tantrum or meltdown)
  • This is a choice – or – This is not a choice
  • Thinking with your eyes (i.e., learning to use your eyes to communicate)
  • Thinking with your body (i.e., learning to use your body to communicate)
  • Another way (e.g., used to let the youngster know that you don't like the behavior or tone of voice he/she is using, for example, "Can you try another way of saying that?")
  • The rule (it’s helpful for the youngster to have appropriate responses described as “the rule”; it appeals to his/her sense of seeing the world in black and white; often simply stating that a desired response is "the rule" brings immediate compliance)
  • The preschool way, the elementary school way, etc.
  • That doesn't make sense (i.e., used when the youngster says something that is inappropriate, for example, fantasy talk, mislabeling another's or their own feelings, giving misinformation on a topic, etc.)
  • Tell me what you have to do (e.g., often used after giving directions)
  • Switching – or – substitutions (i.e., key words used to remind the youngster about being flexible)
  • Stretching the topic (i.e., attempting to go off topic by trying to make your new topic – usually a special interest – appear related to the original topic)
  • Stick up for yourself (i.e., refers to the type of response the youngster must make when being teased or taken advantage of by others)
  • Show me (i.e., add the phrase for what you want the youngster to do)
  • School sitting, school walking, etc. (i.e., refers to a specific manner of doing something that has been demonstrated to the youngster previously)
  • Say one thing (i.e., when answering questions or discussing a topic with too much detail – this skill should be practiced)
  • Salvage the rest of the day (i.e., refers to not allowing a problem to ruin the rest of the day)
  • Respond Quickly and Quietly (referred to as Q and Q)
  • Problems and Solutions (i.e., refers to a technique used to either prevent a tantrum or assist the youngster in regaining control during a tantrum; referred to as P and S)
  • Personal space (i.e., not touching others when it is not appropriate)
  • Off the topic (i.e., said to the youngster when his or her response is not on the topic being discussed)
  • MYOB ("mind your own business")
  • Lower – or – raise your volume (i.e., to help the youngster to modulate voice volume; often paired with a hand signal)
  • Look and Listen (referred to as L and L)
  • KISS ("keep it small and simple")
  • Keep your problems small (i.e., used when the youngster's behaviors are just beginning to escalate in a negative way; serves as a reminder to maintain control)
  • Just do it (i.e., refers to times when the youngster must quickly respond in a particular way without question)
  • In your head (i.e., refers to statements that should not be said aloud, usually statements about a person's physical appearance or statements that would hurt another's feelings)
  • Good choice – or – bad choice 
  • Get your control (i.e., key phrase used during a crisis)
  • Eyes up here (i.e., key phrase to help with attending and focusing)
  • Drop the subject (i.e., refers to talking on and on)
  • Don't get stuck (i.e., refers to not allowing a problem to control you or stop you from moving on; this skill is taught)
  • Don't be a "me first" (i.e., used with those kids who have an obsession about always being first in line, when playing a game, being called on, etc.)
  • Dealing with disappointments (i.e., refers to what to do when something doesn't go the way we thought it would)
  • Conversations go back and forth (i.e., used as a reminder when learning how to converse with others)
  • Bumping (i.e., refers to interrupting others when they are speaking)
  • Being okay (i.e., getting yourself together to handle a situation)
  • Being flexible (i.e., used when the child is upset with a routine change)

What moms and dads say is important, but “how” they say it can make the difference between compliance and noncompliance in their child on the autism spectrum. Sometimes a quiet, calm voice is needed. At other times, a firmer tone may be called for.

When you change the tone of your voice, point it out to your youngster. Kids on the spectrum don’t usually use varied tones of voice to convey different meanings. By pointing this out, you communicate your meaning, and you increase your child’s awareness of the importance of paying attention to vocal tone.

Also, this should be done with facial expressions and body language – two other things kids on the spectrum don't use when communicating to - or processing communication from - others. Vary your facial expressions and body language, and explain/show how it helps people to understand what others are saying.

Resources for parents of children and teens on the autism spectrum:
 
 
More articles for parents of children and teens on the autism spectrum:
 
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

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Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

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Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

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Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

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Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

Click here to read the full article...

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Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...
 
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A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...
 
 
 
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