Disruptions to our regular routines are part of everyday life. In fact, for most of us disruptions are routine! However, for those with autism, changes to routines and rituals can be an extremely stressful situation.

As parents of children or young adults with autism will know, they may have very particular routines and/or rituals that they struggle to sway from. The complete insistence for routine is deeply emotional and so change can be exceptionally uncomfortable and difficult for them, causing a great deal of anxiety.

How are routines and rituals helpful?

For people with autism, routines and rituals represent safety and certainty. For many they will be invaluable tools to help them cope with emotions like anxiety, depression and other emotional lows. Those with autism can naturally have anxious and active minds, so high degrees of predictability and repetition in their lives is a key way to bring comfort and to self regulate a sense of calm.

By and large, routine is absolutely a good thing. Here’s why:

Stress management and relief

For all of us, routine has been shown to relieve stress levels. Predictable is, by default, somewhat calming. We do not need to worry about the unexpected if we know exactly what is going to happen. For a child or young person with autism, routine is therefore a really helpful way for them to find a sense of calm in an otherwise stressful, confusing world.

Innate skill

Those with autism are predisposed to enjoy high levels of repetition. It is one of the key early stage indicators observed prior to diagnosis. As routine comes naturally to them, they are better able to settle into healthy, productive patterns.

Settles the restless mind

For people without autism, the layers of everyday stimuli that bombards them (visually, audibly etc.) feels normal. However, to those with autism, this cacophony of input can feel incredibly uncomfortable. Routine helps to cut through this ‘mess’, allowing the mind to focus on one thing at a time.

Learning aid

Almost by default, a calm mind is a more receptive mind, so there is significant benefit when it comes to learning. As soon as stress is minimised, new knowledge, skills and habits can be achieved more readily. By having a regular rhythm and a routine, a sense of order out of the chaos can be found.

So what happens when change occurs? Change, afterall, is a part of everyday living and it would be impractical to establish routines that do not allow for a degree of adaptability.

Change, however, comes in two forms: expected and the unexpected. Let us first consider how to work with anticipated changes.

If your child has autism, how can you plan for expected changes in their routines?

Communication is the bedrock for effectively, and more easily, managing the response to change. Anticipated changes to the routine like a dentist appointment, a birthday party or a visiting relative can be prepared for comfortably in advance of them taking place.

The benefit of anticipated changes will usually also include a good amount of additional time to adapt: the greater amount of time between now and the expected change, the more likely your child is to better adapt to the amended schedule. So, what strategies can be used to help integrate change?

Stories

Storytelling is a powerful tool that can be used to help prepare a child for those moments of expected routine change. If, for example, the change is a result of a dentist appointment, it may be helpful to create a descriptive story that paints a clear picture of the experience beginning with getting ready to leave the house right through to what will happen at the dentist’s. It is critical, however, that the story is upbeat and ends on a positive note. You can do this by reinforcing how it will be a fun adventure, how visiting the dentist is very important and healthy and how afterwards there will be a visit to the park or an ice-cream vendor.

Timetables

Timetabling a schedule is a fantastic, visual way to help your child see their week/day and know what to expect. They provide clear structure and highlight exactly what to expect and when. For example, if the anticipated change to a regular schedule is a birthday party next week, you can involve your child in adding it to the timetable, perhaps with a fun sticker or colourful pens. It can be helpful too to use moments in the day, like ‘dinner’ or ‘bathtime’, rather than specific times, to help alleviate any tension should your child have anticipated leaving the party at 4pm, rather than after ‘cake’.

Clocks and alarms

Another helpful way of encouraging your child to prepare for changes in their day is to use a timer or a countdown. These can be a handy way to create a sense of fun for a child with autism - the bell is ringing, so it’s on to the next activity!

For young adults with autism, who are learning to be more independent, the ability to prioritise, schedule and plan can be more difficult, especially if they find themselves often getting carried away with a task and forgetting other responsibilities or appointments. Alarms will allow them to immerse themselves in the task at hand, knowing a friendly reminder will prompt them when needs be. For instance, if they are due to go to their weekend job at 1pm, setting a timer to chime at 12:30pm will give them time to transition into the ‘leaving the house’ routine.

How to manage unexpected changes in routines and rituals

As we have established, routines and rituals are great, but there are never guarantees that they will go forever unbroken or undisrupted. However, unexpected disruption and change (including expected change) will always be a part of life. So how can parents and carers of children and young people with autism prepare for and, ultimately, manage unexpected disruptions to established routines and rituals?

Like all good planning, preparation begins during times of normalcy. Why? Because this is when your child is most calm.

Make ‘change’ part of the routine

It is common for routines to be represented visually such as using a nice big colourful weekly calendar that clearly maps out the schedule.

We can actively normalise the concept of change into this by simply leaving space on the calendar. This will provide the opportunity for you and your child to fill in at any time. This could itself become almost ritualistic: adhoc responsiveness. Defining these moments together, at the latest possible time, will subtly introduce the notion of unexpected change to the routine.

By doing this you will be acclimatising your child to the notion of unpredictability. If they are encouraged to see these spaces each week as moments of surprise or mystery, they will gradually come to see this as comfortable, rather than stressful.

How can this be done?

If we have a blank space on the timetable, we can use a special character or colour to indicate ‘unpredictable’. Perhaps a funny face with a question mark by it could be a light way to begin this association.

The first stage will be the softest. Let us imagine that the funny face is placed between 1 and 3pm on the last day of your weekly timetable. Your child will know that something is going to happen then, but not what. It will therefore be important for the ‘what’ to be enjoyable: a trip to the countryside or a visit to the local animal farm.

Once your child has become comfortable with this process you can then progress to the next level by reducing the number of days of anticipation between now and the funny face on the timetable. By decreasing the amount of time your child has to prepare for the unknown event you are gradually encouraging them to feel more comfortable about it.

By the time this has started to feel comfortable for your child you can begin experimenting with small deviations from the plan. For example, on the way back from the animal farm you could make a small detour to stop for petrol or a small groceries run.

After this has become acceptable you can try leaving the space blank entirely, making a game out of only filling in the funny face on the timetable at the last minute. Encouraging your child to make suggestions about activities to do during this time will be a great way to involve them in the process.

Of course, this technique can also be used in combination with some of the above suggestions too. Try building storytelling into the process to help your child actively, creatively and positively imagine how this time can be spent.

Make flexibility something to shout about

For older children, the notion of surprise and mystery can be developed and reinforced as ‘flexibility’. This can then be treated as a skill to champion. By rewarding your child’s ability to adapt to change and the unexpected, either through encouraging words, attention or treats, you will be helping to condition them to consider it a good thing.

Where can I get additional support and information?

If your child has autism and you would like further information or guidance, you can find some wonderful resources and support networks through the following:

• Autism.org.uk
• Child Autism

The NHS also has a fantastic directory of support groups that can be searched in accordance with your need, which can be found here.

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