Routines, Predictability, and Just Getting to School in the First Place

[Thanks to Danette Schott at Help! S-O-S for Parents for including this as part of her February "Best of the Best" feature on school issues as they relate to invisible special needs! Go read all the great posts she's collected this month from some top notch bloggers, and while you're there check out the previous editions of "Best of the Best".]

Getting to and from school has often been quite the adventure for us over the last three years. We’ve enjoyed mornings that are smooth as still water, and we’ve survived mornings that have involved broken objects, personal injuries, shot nerves, and crying from adult and child alike.

The uninformed masses have been known to ask what a ‘normal’ morning looks like for us. After I pick myself up off the floor from laughter, I might offer the response, “Normal is a dryer setting, and ours still leaves the clothes damp. But I can tell you what gets us out of the house in one piece more often than not though.”

Children like ours often find comfort and stability in routines, so try to keep things as predictable as you can in the mornings. Don’t overdo it, though, as you want your child to continue learning and practicing adaptability. However, always start from a place of trying to be understanding of their needs. What may seem trivial and annoying to us may mean the world to them. Consider all sides of the equation as you develop and adapt your routine.

If you currently don’t have much of a regular morning routine but you think this is even remotely possible for your family, work on developing one. (If y’all have newborn triplets, for example, you may be on your own.) Just remember that even a change from chaos is still change for our kids, so whatever you do, introduce a schedule at a pace that moves your family toward your goal without pushing too hard. It’ll be challenging enough at first, and your kids might react strongly, but stick with it. In the end, it’ll get better, and you’ll be glad you did it.

Let me walk you through our morning. Whether it’s typical or not is beyond me. If our J-Man – who, by the way, is 5 1/2 – hasn’t already gotten up at some other hour, we wake him early enough that we can get everything done and be out the door without having to push too hard. Typically an hour before we need to leave for school is sufficient. We also budget in some extra time if we’re waking him from a dead sleep because – like his daddy – he is slow to get moving. A tired, autistic kid yanked out of bed quickly is about the equivalent of a sackful of angry cats.

If he’s gotten up really early (i.e., before us), then we often try putting him in bed with us until the time we normally get up. This has had mixed results, but the idea is that we’re trying to impress upon him the idea of not starting the day until a certain time. Getting him on a somewhat consistent sleep schedule has been a multi-year project, and it doesn’t take much to throw him off. But regulating sleep is one of your keys to success, and sanity for that matter, so focus whatever resources you can there.

Once we’re all up, next stop is the shower. We stumbled on the shower as an important part of the morning by accident. He used to strip down and pee in his bed every morning, so we had to wash him anyway. We discovered that he enjoyed the shower, and this got the day started on a better foot, so we kept doing it. As a result of working on this specific routine for a while, he knows now that when he gets to the bathroom, he stands in front of the shower, waits until we say the water is ready, then he takes off his clothes, puts his clothes (sometimes) in the dirty clothes pile and his diaper in the trash can, gets in the shower, and we close the shower door.

He loves water, so we let him stand there for at least a couple of minutes. He may just stand still, but often he lines up the bottles of soap and shampoo while the water runs on him. This has seemed like a gentle transition to ease him into the morning, so we allow him time for that. We help him shower, dry him off, and he has to hang up his own towel. Then often he wants to line up things on the counter before we’re done in the bathroom. We allow up to about a minute of this. That seems like enough time to let him get what comfort he gets out of that but not so much that he gets stuck in an endless loop. And then (often with a lot of prodding) he goes to his room where we get him dressed. It’s these transition points in the routine (e.g., going from bathroom to bedroom) that have been among the most challenging. Practice, practice, patience, practice.

A bit on ‘rituals’: We use this term to mean any sequence of things our J-Man feels like he needs to consistently do in a certain situation before he’s ready to move on. Many people refer to these as ‘meaningless’ actions or actions that aren’t related to the task at hand, but I know they aren’t meaningless to him. The term ‘rituals’ has taken on negative connotations in autism, and I don’t think this is helpful. The rituals many of us perform in a worship service, for example, may seem meaningless to others but not to the person worshipping.

We do try to set boundaries, however. He probably would stand at the bathroom sink and line up objects for half an hour if we let him. Instead we give him a short period of time, even help him with the lining things up, cue him that it’s time to go to his room, and with some persistence this seems to have worked. A visual timer or a visual countdown mechanism such as a strip with numbers on it and ‘Finished’ on the end where you can pull off the numbers one at a time as a countdown may help structure transitions for your child. We’ve leveraged our son’s enjoyment of numbers to get to where we can verbally count instead sometimes.

However you handle it, I don’t recommend abolishing these rituals unless they are somehow destructive or harmful. For example, the J-Man wants his right sock on first then his left, same with the shoes. There’s no harm in this, so that’s how we do it. Instead, try to understand why your child wants to do things a certain way and find means to help them get the personal benefit out of this that they seek.

Over time, we’ve worked to periodically add new things into the routine that he himself has to do so we can help him learn independence skills. We used to help him out of his clothes; now he does that. We used to hang up his towel; now he does. He helps some with his dressing now too. By doing this, we employ a method similar to one they use at school: introduce a new skill, work with him, fade out the help as he becomes more independent, then when he has mastered it, we add a new one.

Visual schedules can be really helpful especially if morning schedules in your house are just going to be somewhat unpredictable all the time. If your child gets uncertain about whether it’s a school day or not, by putting a simple school/no school pic on the calendar you can give them a clear visual about the day. Visual schedules are very helpful when establishing a new routine, and sometimes you don’t need a lot. A simple schedule of Get Undressed, Shower, Dry Off, Go to Room, Get Dressed, Eat Breakfast, Go to School might be sufficient. The idea is to either make things predictable by habit or by giving a visual roadmap of what’s coming up next.

Dressing and clothing has been an ongoing challenge for us. For the longest time, he was attached to one pair of shoes and one particular coat. The shoes weren’t a big deal, but obviously he needs to wear a coat appropriate for our constantly varying weather. So between home and school, we practiced different coats at times where if he became upset it didn’t matter if we had to wait a while to leave the house, such as a Saturday trip to the store. At school they created visuals with photos of different coats (the actual coats – some of which we borrowed just for this experiment), which were then paired up with the photo of the shoes he would wear. So the visual might be: Thursday – picture of blue coat – picture of navy shoes. Every day would be a different pair. First couple of days were a real struggle, but then it got easier fairly quickly, and before long we didn’t need the schedule anymore. We’ve even gotten this to tentatively work with winter clothes he hates such as hats and mittens. Borrow a variety of practice clothes or stock up on hand-me-downs or items from Goodwill. Be careful, though, and be on the lookout for sensory aversions for your child such as fabrics, tags, etc.

To introduce deviations from the expected routine, try to mix things up a bit at times where if everything goes to pieces, you can fall back and regroup without stressing over needing to be somewhere. A non-urgent, Saturday trip to the store might be a good time to experiment. If you don’t get around to going, no big deal. You can even just try to get ready, get in the car, drive around a few minutes, and come home. You may very well be able to do a few practice runs in one day this way.

We’ve also addressed other issues in this way. The J-Man used to be very adamant about only wanting to get in and out of the car at school if we were parked in a handicap space. We’ve had full-scale collapses and complete panic trying to get him into his car seat in a different parking spot, which a couple of times resulted in wrist sprains for me. We actually went to the school on the weekends and practiced parking in different spots. We’re a bit surprised this helped since going to school on a weekend is a major deviation from what we normally go to school for, but it did seem to help. I still don’t take chances and try to get there early enough to get a handicap spot. The rule here: don’t tempt fate too much!

Be on the lookout for last-minute deviousness, too. Our J-Man has a tendency to get spontaneously and magically hungry right when we say it’s time to go. He does this at bedtime too. This is at least more constructive than having a tantrum to delay doing something, but it still causes issues when we’re in a time crunch. Try to budget in time to deal with this. Announce it’s time to leave earlier than you need to. Address whatever your child then does. If the behavior trends toward the tantrum end, consider trying whatever calming sensory interventions work for your child, such as deep pressure, brushing, music, etc. Adding something calming into the routine can make transitioning to school more pleasant for them.

We set up the leaving the house routine as brushing teeth, putting on socks and shoes, putting on a long-sleeve shirt, and then putting on his coat. When summer rolls back around, brushing teeth then socks and shoes will still work. Announcing this becomes his cue that we’re getting ready to leave. By making these cues consistent and predictable, he trusts them and knows what’s coming next even without a picture schedule.

Sometimes you can’t negotiate, though. His MedicAlert ID bracelet goes on the second I have him strapped in the car. It comes off the minute we get home. It must stay on all other times when he’s outside the house. This is not negotiable. We were firm about this from the minute we got the bracelet, but after a few really difficult days, he accepted it and now wears it when we’re not home with no complaints. Also, if your child refuses to eat all morning, keeps deciding at the last minute to eat (or do whatever), and this ends up making you consistently late for school, I think it’s OK to say no and firmly state it’s time for school. The first few times this will suck. This may sound like a harsh method, but if he’s turned away food all morning, clearly he’s not starving. He’s learning that routines have boundaries, and there are indeed consequences to certain choices. This is an important lesson for all kids.

In short, there’s no magic way to fix morning struggles. All of us will have different routines, and we each must develop one that works for our family. Unfortunately, this is often just trial and error, but you do get better at it. Brainstorm with other parents, teachers, and therapists who can offer fresh perspective and ideas and see things from a more objective distance. Anything new you try will at first be met with a lot of resistance, and you might have to make steps backwards to go forwards. Be prepared for this, but be persistent, too. You’ll begin to make incremental gains that will add up over time. Better mornings make for better school days for our kids and better emotional health for parents!

Posts that hopefully are similar:

• Like a candle
• Strategies to Help Our Kids Return to School
• Where Am I?
• When the Only Thing Routine is the Lack of Routine
• What’s Your Autistic Toddler Like Now? (Part 3)
• You Kinda Get Used to Weeks Like This
• If ignorance is wisdom, we’re all gods here

Tagged as: Advice, ASD, Autism, Behavior, Coping, parenting, Preschool, School, Sensory Issues, Sensory Processing Disorder, SPD