The daily care of a child with autism spectrum disorders (ASD) can often seem overwhelming. Meeting their physical needs, responding to their emotions, creating an appropriate environment, and helping them learn is an ongoing challenge.
Although every child is unique and the level of autistic tendencies varies widely, there are some factors that have been found to make caring for a child with ASD a little easier. The following are some of the most effective ways to help you and your family live with a child with ASD.
All children benefit from a consistent routine. However, a routine is often a necessity for a child with ASD. Involve all family members in the decision of what the routine should be. Individual needs, temperaments, schedules, and commitments should be considered. The routine allows the child with ASD to predict the day's events, which should bring security. Janice, a mother of 3 boys with ASD, ages 19, 10, and 8, says, "I found that a routine helps to keep confusion out of their already confused world. If the routine needs to change, I let them know ahead of time."
Establish a set time for meals, bath, play, activities, shopping, school, friends, and bedtime. Abide by the routine as much as possible. Be sure that family members, friends, teachers, and neighbors are familiar with the routine so they can be supportive.
Sometimes circumstances beyond one's control and the demands of the day interrupt the routine. It is common for the child with ASD to protest the change with undesirable behavior, such as screaming, self-inflicted injury, destructive behavior, or verbal attacks. Although the parent understands the reason for the negative behavior, it is important that they respond with the same consistent consequences. Then, return to the routine as soon as possible.
Many experts feel that a consistent environment is the best tool available for children with ASD to learn. Consistency in the daily routine, discipline, communication, social interactions, and experiences all contribute to reinforcing their learning environment. Children with ASD have trouble transferring what they learn from one experience to another. For example, they may use the proper sign language for drink when they want a drink at school, but may stand in front of the refrigerator and scream when they want a drink at home.
Enforcing the consistency requires a great deal of communication between parents, family members, teachers, and other caregivers. Beth, the mother of 2 boys with ASD, ages 8 and 5, says, "When my youngest son was in the special needs preschool, they used picture cards to help him communicate. They suggested that I make the same picture cards to use at home. This helped us communicate better with each other."
Many parents of children with ASD do not discipline because they are unprepared to handle the negative behavior. Although there is no magic formula for disciplining any child, many parents believe that behavior modification is most effective in changing the negative behavior of a child with ASD. In most cases, if positive behavior is followed with desirable consequences, the child will repeat the behavior in order to gain the reward.
Be specific when rewarding the child. Verbalize exactly what behavior earned the reward. Instead of saying "Nice job," say "Thank you for picking up the toys." The child will be more likely to associate the positive behavior with the praise.
Tangible rewards are sometimes necessary since social interaction is oftentimes undesirable to a child with ASD. Privileges, stickers, toys, and tokens can be used as effective rewards. Immediate rewards are usually most effective during the early years, while delayed rewards can be effective with older children. Rewards such as candy are usually effective, but not recommended because they can cause other problems. Janice says that she uses a token system for good behavior. She has a chart for each son on the refrigerator. When she witnesses a good behavior, she allows them to put a sticker on the chart. When her sons collect so many stickers, they get a reward, such as a video, toy, or a special treat.
Investigate the programs in your area and select the one that best meets the needs of your child. It is most common for a community to have home-based, school-based, and private programs available. A positive educational program is a key factor in determining the child with ASD's future. Therefore, it is important that parents take advantage of early intervention programs, seek out the best schools, and continue to evaluate the educational program in which their child is involved.
In a home-based program, the teacher and a variety of therapists will come into the home and work with the child with ASD in developing skills in areas such as communication, behavior, and socialization. They often work with the parents as well as the child.
School-based programs are usually taught by licensed special education teachers and therapists and are located in public schools or private facilities. Some programs are restricted to children with special needs, while others integrate children without special needs. These programs usually offer more structured learning activities with a distinct emphasis on socialization. When evaluating a program, consider the following:
When the child is school age, there are also a variety of programs available. Many programs are provided by the public school system and offer mainstreaming, where the child participates in classes with children who do not have special needs. Some programs are held in centers with just students with special needs—possibly just students with ASD. Regardless of the location, most school programs offer structured learning activities, specific curriculum goals, individualized instruction, special services, and parent education.
Even if the program does not have a structured parent education program, it is important for the parent to be active in the child's education. As mentioned earlier, routine and consistency are necessary for children with ASD. It is difficult for this to occur unless the parent and teacher work together.
Parents are the greatest advocates a child with ASD can have. Becoming informed and staying current on the latest research enables parents to be even more effective.
Autism Society of America
Healthy Children—American Academy of Pediatrics
Autism Canada Foundation
Caring for Kids—Canadian Paediatric Society
Autism spectrum disorders. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T113665/Autism-spectrum-disorders. Updated April 29, 2016. Accessed. May 22, 2017.
Autism spectrum disorders (ASD). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/ncbddd/autism/index.html. Updated April 3, 2017. Accessed May 2, 2017.
Autism spectrum disorders: Guide to evidence-based interentions. Missouri Department of Mental Health website. Available at: http://autismguidelines.dmh.mo.gov/documents/Interventions.pdf. Accessed May 2, 2017.
Helping children with autism thrive. Help Guide website. Available at: https://www.helpguide.org/articles/autism/helping-children-with-autism.htm. Updated April 2917. Accessed May 2, 2017.
Last reviewed April 2017 by Michael Woods, MD, FAAP Last Updated: 5/2/2017