Those dreaded public meltdowns. Most parents of kiddos with autism have faced this ugly beast of a problem at least once—and once is more than enough. Fortunately, such meltdowns needn’t be a fact of life with autism.A parent asks: My son is nearly four and has high functioning ASD. We have had some challenging times lately with battles of wills. We just had a failed trip to Target because he no longer wants to ride in the cart and if I let him walk, he runs the aisles and pulls things off shelves. When I catch up to him and tell him he must get in the cart, it’s an absolute screaming fit and we have to leave the store kicking and screaming. I could deal with this when he was two and I could easily pick him up, put him in the cart and strap him in for his own safety, but the straps barely fit around him now and soon he will be too heavy for me to easily control. I need better strategies. I am a big believer in positive reinforcement and creating situations where he will succeed, but sometimes we just need to go to the store whether it will be a success or not.
Ellen answers: After an outing like this, both of you may feel apprehensive about the next trip. But with planning and patient, consistent teaching, outings with your son needn’t be a battle of wills. The key is to build competence and tolerance in increments that are manageable for him. As a parent who has lived this myself, here are my suggestions:
1. Four is not too young to begin teaching that some things we do because they are have-to’s. This is true for everyone at every age, and you can help him understand this by pointing out things in your own daily routine and those of family members and people in the community that are have-to’s. Explain also that have-to’s can be followed by want-to’s, then follow up by demonstrating this. When you impose a have-to on him, such as that trip to the store, his success will earn him a want-to. Be very explicit about what constitutes success and what the reward want-to will be. Support this with visuals.
A word about rewards vs. bribes: reinforcing his cooperative behavior with a want-to is not a bribe. When we do our jobs, we get paid. His want-to is the currency of the moment for doing his job, which in this case is helping you with the shopping. He’s not too young to begin learning the concept of age-appropriate responsibilities within the family.
2. No surprises. Respect that impromptu outings can create anxiety for many children with autism, and can invite resistance. Schedule the trip to the store ahead of time and build it (and the want-to to follow it) into a visual schedule of his day so he knows what’s coming and what he can look forward to afterward. You might even want to give 15-minute or 5-minute warnings leading up to the outing, using a visual timer.
3. Timing is everything. Don’t pre-dispose your son to failure by scheduling the outing for a time when he is likely to be tired (end of day or right before nap), hungry (right before lunch) or unhappy (is missing his favorite show). Minimize the time needed for the outing and the potential sensory overload by shopping at times when the store will be less crowded.
4. Mitigate sensory factors as much as possible. Huge, windowless, artificially lit stores can send children with autism into sensory overload. Fluorescent lighting flickers and hums, tens of thousands of items on the shelves create visual overstimulation, sounds (echo-y, screechy—loudspeaker, overhead music, kids crying, people all talking at once) and smells (people, products) overwhelm him, the store may be air-conditioned or heated to an uncomfortable degree. Giving him something to do and focus on while you’re shopping can help. Try giving him a set of index cards on a ring, with photos of the items you’re buying that day (cut pictures from the store’s ad or get them off the Internet.) Ask him to help you match the item on the card with the item on the shelf (does double duty as teaching the beginnings of independent living). Or simply keep a set of fidget toys that he only plays with when seated in the cart at the store. This keeps his hands busy and his eyes focused on a single thing. Listening to music on headphones might also work. You might also create a visual of the parts of the trip so he can see at all times what comes next: 1) get in car, put on seat belt, 2) drive to store, 3) walk from parking lot, 4) get items (sitting in cart or walking), 5) go through checkout line (give him job such as handing over money or swiping card), 6) walk to car, strap in 7) drive home, 8) reward/want-to!
When transitioning to walking rather than riding in cart, establish rules such as, perhaps, hands in pockets and/or not moving farther away from Mom or cart than he can reach out and touch. Have a visual prompt handy, or develop a one-word prompt or fun code word to remind him when he strays.
5. Keep the trip as short as possible. Have a list, share it with him, then stick to it. Keep your word. If you tell him you will be buying a birthday card for Uncle Steve, a box of laundry soap and batteries, buy only those things and don’t even browse for others. Even when the outing is going well, resist the temptation to squeeze in “just one more thing.” That may be the tipping point between success and disaster. It also teaches him that he can’t trust what you tell him.
6. Praise his success, both immediately following the outing, and by telling family members about it later so they can acknowledge his accomplishment too. Reinforce that he has helped you; this will work to instill in him that he is a full-fledged member of the family, with responsibilities appropriate to his developmental (not chronological) age.
7. A social story can reinforce the behaviors you expect of him on an outing, and reaffirm his ability to do it. If you are unfamiliar with social stories or unsure how to write one, visit http://www.thegraycenter.org/social-stories/how-to-write-social-stories.
8. Remember that the way things are today is not the way they will always be. Honor your child’s needs and abilities while you teach and build his skills, knowing that he will grow and progress.