The famous quote says that the only constant is change. And the longer I live, I find this to be true. There are the big changes that we experience in life - changing schools, getting new jobs, moving from one state to another, getting married, becoming a parent. There are those changes that are momentary - change in environment when you go on vacation, for instance. And there are those fixed changes, like those that we experience in nature with the change in the seasons which happen at fixed intervals. And still there are those small transitional changes - those that we experience multiple times a day as we transition from the various activities in our daily lives, going from home to work, going from meeting to meeting, coming home from work and transitioning to the shower. Small, minute transitions that help us navigate our day.
I recently started thinking about just how many changes we experience in one day, and really started to think about Becca and how challenging her days must be at times. Autistic individuals thrive on routines and predictability, and deviation from their routines can be a major source of anxiety. I have experienced this firsthand with her. Sometimes the simplest transition, like moving from the car to the house, can trigger a meltdown.
Thankfully, we have found some ways to help alleviate her stress and so she has gotten better at navigating through the various activities of her day. But getting to this point has not been without its challenges.
When we can anticipate a change in routine, we try our best to prepare Becca in advance. If we know she will be missing school, or if she is going back to school after a vacation, we explain to her that her routine is going to be interrupted. This helps her prepare herself mentally for the upcoming interruption.
Preparing for medical procedures can be a little harder, depending on what the procedure is. A few months ago, Becca had to do a sleep study, which required an overnight stay in the hospital. It also required that Becca be connected to a machine all night, with probes on her head and her legs and her arms. Becca has sensory sensitivities and so we were concerned that she would not be able to get through the sleep study. To prepare her, we purchased electrodes and placed them on her skin in the weeks leading up to her procedure. We also explained that she would be having an adventure and that we would be sleeping in a room with wires just like "Robot Shark". Another time, she had an echo-cardiogram scheduled, and we showed her videos on YouTube on kids having the procedure and told her that she would have the adventure of doing the same and that we would get to see her heart beating. In all of these cases, her routine was going to be interrupted. But in all of these cases, with a little bit of advance preparation, we were able to get through the change in schedule without any meltdowns.
While these are all pretty big changes in routine, we apply the same concept for the smaller, mundane transitions. Last week, Becca attended a birthday party at a friend's house and they had a big trampoline. Becca was in heaven! But when we had to get ready to transition so we could sing happy birthday, we had to give Becca enough time to transition from the trampoline to the canopy. Rather than asking her to leave the trampoline just in time to sing, I approached the trampoline to tell her that she had ten minutes left in the trampoline, and then we were going to the canopy to sing happy birthday. Then, I set my timer the ten minutes. When there were five minutes remaining, I went back to the trampoline to inform that she had five minutes left. I also reminded her at the two minute warning. Then when the ten minutes were up, I approached the trampoline, asked Becca to let me put her socks back on, and she came out of the trampoline. No protests, no crying. I reminded her that it was time to sing happy birthday, and that afterward we would be heading home. She sat in the chair under the canopy and hummed along as we sang happy birthday, then waited with us as we packed up. And while she didn't quite want to leave (she did turn to run back to the house), the constant communication of next steps helped keep any potential anxiety at bay.
Communication has been so important - not just us communicating with her, but her communicating back to us. With a nonverbal child, we have had to learn how to communicate in a way that she can understand - and we have had to learn her language. We have learned to closely observe her likes, her dislikes, her behaviors in various situations, her mannerisms when she is getting overwhelmed, specific activities that might overstimulate her. And by the same token, what her sensory needs are and ways to calm her in the case that she is having a rough time. And we use these precise ways to help her during transitions. In addition to the constant verbal communciation, we also use her AAC tablet, visual cues, and comfort items.
Comfort items are those items that soothe, relax, and promote overall wellness. Each person will have different comfort items depending on their needs. Becca has a perferred blanket, oils in a diffuser, rubs, fidgets, weighted blankets (she even has a weighted teddy bear that her uncle bought her). So we carry around some items that can provide comfort in the case of a challenging transition - fidgets, play-doh, her headphones, even Vicks which will often help her calm down in the middle of a meltdown.
The more I get to know this wonderful little girl that GOD has entrusted to our care, the more in awe of her I am. The many tiny transitions that I make throughout my day - that I make without giving them a second thought - are often quite challenging for my Becca and the millions of other people on the Autism spectrum. Yet, she handles them with a strength and a grace that I admire greatly.
So if you know a child who struggles with transitions or changes to their routine, approach with understanding and calming strategies. They are often fighting challenges that we can't begin to imagine, and with the right supports in place, they will handle these challenges like the champions that they are.
