As an autism educational consultant, I am often called into schools to analyze an educational program and make recommendations for an autism spectrum student in crisis. Generally the student's inappropriate behaviors are through the roof, the teachers are unhappy, the parents are upset and the student himself is confused and angry. Sometimes, behaviors are to the point that the student is sent to a self-contained classroom because s/he can no longer be tolerated in the general education setting. Frequently, when I start asking questions and assembling information, I invariably learn that the routine has been changed in some way - there is a substitute paraprofessional, the teacher is out on maternity leave, the school is back in session from an extended break, art class has been cancelled for a school-wide assembly, etc., etc., etc. When changes occur for someone with an autism disorder, behaviors will ensue. Wasn't it Newton who said "for every action there is an equal and opposite reaction??"
Individuals with autism spectrum disorder function so much better when routines are predictable. When a major change occurs, everything gets thrown off and the child ends up confused and upset, trying to figure out a new set of rules. In this episode, Gaby, Max's therapist, announces that she will no longer be working with Max and abruptly leaves. As any parent of a child with ASD can imagine, this upsets everyone - Adam and Kristina, and especially Max, who can't accept that Gaby won't be back. His reaction is understandable: Any child, with or without an autistic disorder, would be sad and upset and need comforting. But Max has a much harder time accepting and understanding this than a typical child because of his disorder. How do the adults explain a change in routine when they don't understand it either? Kristina beats herself up, thinking that she is the cause of it, that she has been too harsh or that Max was too difficult to work with. Regardless of the reasons, this change has a negative effect on all involved - especially Max, who is now without his therapy sessions.
Does this mean that we should always ensure that everything is predictable for those with ASD so they won't get upset? That daily routines should never change and that schedules stay the same forever? After all, isn't it true that those who have ASD function better with stability (as everyone else does)??
Unfortunately, of course, the real world is filled with thousands of changes and events that challenge an individual's flexibility on a daily basis, something with which those with ASD struggle. Many years ago, while attending a conference, I heard Temple Grandin explain it best: The difficulty with changes for those with ASD is not the 'change' itself but the 'surprise' factor involved.
Max, for example, would have better understood that Gaby could not work with him any longer if he had a transition plan in place. A transition plan would most likely include a gradual reduction in Gaby's therapy sessions with an overlapping increase in time spent working with a new therapist. Eventually (the length of the transition will vary with the individual's needs) Max could have understood that he would see Gaby less and less and would have been able to accept this major change in his life.
Individuals with ASD can learn to be flexible and can accept any number of changes in their lives, but they need preparation, explanation and time to absorb these changes into their daily routine. This skill should be viewed as another area for direct instruction, and with enough practice, those with autism spectrum can accept a degree of the "surprise" factor to the changes occurring in their lives. When I am working with a school system on a student's program, transition planning is a large force for positive behavior changes. Parents and adults working with those with ASD should not automatically assume that the underlying reason for an inappropriate behavior lies with the individual with ASD; too often, it lies with the adults around them and the lack of transition programming. So unless a student can receive the proper instruction in changes, let us all keep "the surprise" factor for birthdays.
Written by Sheila Wagner, M.Ed.