
By Virginia Reece, MS
The daily care of an autistic child can often seem overwhelming. Meeting their physical needs, responding to their emotions, creating an appropriate environment, and helping them learn are an ongoing challenge. But adopting a few basic guidelines—such as maintaining a routine and reinforcing positive behaviors—should make things easier for you and your child.
Establish a Routine
All children benefit from a consistent routine; however, a routine is often a necessity for an autistic child. 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 autistic child to predict the day’s events, which brings him security. Janice, a mother of three autistic boys 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 autistic child 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.
Be Consistent
Many experts feel that a consistent environment is the best tool available for autistic children to learn. Consistency in the daily routine, discipline, communication, social interactions, and experiences all contribute to reinforcing their learning environment. Autistic children 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 two autistic boys, 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.”
Reinforce Positive Behavior
Many parents of autistic children 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 autism. In most cases, if positive behavior is followed with desirable consequences, the child will repeat the behavior in order to gain the reward.
Be very 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 often repeat the comment and be more likely to associate the positive behavior with the praise.
Tangible rewards are sometimes necessary since social interaction is oftentimes undesirable to an autistic child. 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, the mother of three autistic sons, 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 accumulate so many stickers, they get a reward such as a video, toy, or a special treat.
Finding a Balance
It is very easy to allow your autistic child to take control of every aspect of your life. In the book Children with Autism, Carolyn Thorwarth Bruey, PsyD, writes, “Your goal should always be to make your child part of your life, not the center of it.”
“In other words,” she continues, “do not allow your child’s special needs to dominate your life. No child benefits from the exclusive attention of his parents, and the rest of the family suffers if this happens. More than anything, the autistic child needs a strong, healthy family that provides unconditional love, consistency, and structure to their confusing world.”