How Do We Help Children with Autism Manage Changes to Daily Routines?

Daily routines can be effective in maintaining calmness in the household, and children with ASD can learn daily living skills through repeatedly experiencing the same daily routines. However, some children struggle with changes to these routines, and it is important to help them learn to manage these changes, so they do not suffer from emotional distress, and are able to adapt and be flexible. 

Children with Autism Spectrum Disorder (ASD) often face challenges adapting to changes in their daily routines due to their reliance on consistency and predictability for a sense of safety and stability (Earles et al, 1998). Routine provides structure to their lives, and disruptions and changes can lead to anxiety and emotional dysregulation (Cardon & Bradley, 2023). Teachers, parents, and caregivers can take several steps to help these children navigate changes effectively.

Gradual introduction of changes

Whenever possible, introduce changes to routines gradually. This approach minimizes disruption and reduces anxiety, allowing children more time to adjust. For example, if parents are aware that the timing that the school bus will arrive will be changed in 1 month, they can prepare the child in advance by informing the child that they will be waking up earlier, and providing visual cues (eg. putting a sticker on ‘6’ and ‘12’ on the clock to signify 6am), and introduce the change in timing earlier rather than later, so the child has sufficient time to adapt to the changes. 

Using visual schedules and social Stories

For anticipated changes, tools like visual schedules and social stories can help children prepare.

Visual schedules: These use pictures and symbols to represent daily routines, helping children understand upcoming activities visually. They also allow children to process deviations from the usual routine when such changes are highlighted on the schedule. Research supports the effectiveness of visual aids in helping students with autism transition more smoothly (Milam & Sutton, 2024). Studies, such as those by Tosun, Özkan, and Eyi̇İP (2023), show that visual activity schedules can enhance behaviours like independent transitions, peer play, and adherence to routines. 

Social stories: These are narrative tools designed to explain upcoming changes in a way that is clear and relatable for the child. Research has demonstrated their effectiveness in reducing anxiety and improving flexibility during routine changes (Swaggert, 1995; Del Valle, McEachern, & Chambers, 2001; Irvan & Syafitri, 2023). There are some apps that provide social stories, and caregivers can even use these apps to create their own social stories that are more specific to their child. For example, “Social Story Creator & Library” on the Apple App Store. There are also websites that provide social stories, such as 

• https://carolgraysocialstories.com/,

• https://autismlittlelearners.com/social-stories-for-school/

• https://autismbehaviorservices.com/social-stories/. 

Reinforcing positive behaviour

Praise and rewards for adapting to changes and demonstrating flexibility can motivate children and reinforce positive behaviours. Practicing new routines or scenarios in a controlled environment can also help build their confidence and preparedness, although this may not always be feasible. For example, when the child is calm when dealing with the change(s), caregivers can reinforce this positive behaviour by giving verbal praise such as “good job staying calm” or “I like how you’re being calm”, and give a strong reinforcer, such as toys, so that the child forms the positive association with being calm during changes. This would encourage them to show such positive behaviours in future instances when they have to adapt to changes. 

Managing sudden changes

In cases of unexpected transitions, sensory supports like fidget toys can help manage anxiety. Fidget toys offer tactile and interactive outlets that assist children in regulating their sensory needs, reducing anxiety, and promoting self-regulation (Roche, Back & Van Herwegen, 2023). 

Individualised strategies

Finally, it is essential to tailor strategies to the unique needs and understanding of each child. Some children may benefit more from sensory support, while others might find visual schedules or social stories more effective. Recognizing and addressing these individual preferences is key to supporting children with ASD during transitions. 

Written by: Tan Yock Kim

References

Bennie, M. (2023, June 5). Coping with changes in routines. Autism Awareness Centre. https://autismawarenesscentre.com/coping-with-changes-in-routines/

Cardon, G., & Bradley, M. (2023). Uncertainty, sensory processing, and stress in autistic children during the COVID-19 pandemic. Research in Autism Spectrum Disorders, 106, 102202. https://doi.org/10.1016/j.rasd.2023.102202

Del Valle, P., A. McEachern, & H. Chambers. (2001). Using social stories with autistic children. Journal of Poetry Therapy. 14 (4): 187–97.

Earles, T. L., Carlson, J. K. & Bock, S. J. (1998) ‘Instructional strategies to facilitate successful learning outcomes for students with autism’, in R. L. Simpson & B. S. Myles (eds), Educating Children and Youth with Autism. Austin, TX: Pro- Ed.

Irvan, M., & Syafitri, P. (2023). The Flexibility of Executive Function: Implementing Social Story for Children with Autism Spectrum Disorder. In Advances in Social Science, Education and Humanities Research (pp. 593–599). https://doi.org/10.2991/978-2-494069-95-4_68

Milam, M. E., & Sutton, K. K. (2024). Using visual activity schedules to improve transitioning for students with emotional and behavioral disorders. Beyond Behavior. https://doi.org/10.1177/10742956241276003

Roche, M. A., Back, E., & Van Herwegen, J. (2023). Parental perspectives on the use of fidget toys and sensory-seeking profiles in autistic and neurotypical children. Current Psychology, 43(17), 15872–15882. https://doi.org/10.1007/s12144-023-05483-3

Swaggart, B. (1995). Using social stories to teach social and behavioral skills. Focus on Autistic Behavior, 10 (1): 1–16.

Tosun, D. G., Özkan, Ş. Y., & Eyi̇İP, Ö. D. (2023). How the Activity Schedules Impact the Children with Autism Spectrum Disorder? A Meta-analysis. Kuramsal Eğitimbilim, 16(1), 1–19. https://doi.org/10.30831/akukeg.1109787