General Strategies to Support ASD

In general with your client, their needs and goals should be considered in a long-term perspective.  Things that are currently not a problem may become more-so over time.  For example, if their misbehaviour increases and they become more physically aggressive and difficult to control, a special “safe room” may have to be created in the house. 

This space would ideally be calming and soothing for them and would allow them to begin to settle down before they lose control.  Typically, smaller spaces, with soft lighting, soft music, and a blanket or something in which to wrap up tight (for kinesthetic pressure) are helpful.

■ To facilitate transitions, make use of visual cues that forewarn the student when something is going to end, stop or be all done.

■ Practice alternative behaviors, such as appropriate communication (e.g., “I need some space”, “I need help”) and relaxation strategies (e.g., find a quiet space, count to 10, deep breathing).

■ The easiest way to deal with difficulties is: a) prevention; b) redirection; and c) withdrawal (removing the person from the situation).

■ Compile a list of things that support your client that bring them security, and which they can enjoy.  These could include objects, activities, people, places, foods, music, etc.  This list will be helpful for family members – in order to help them feel settled and capable in various situations – which will in turn help to prevent emotional and behavioural outbursts.  In particular, these kinds of supports can help them to be successful in situations when there are changes in routine or special activities.  This list will also help others to be able to help him/her, as well as provide for his/her ongoing success.

■ Medication can sometimes be helpful with individuals who have autism, as it can help to stabilize both emotions and behaviour.  It is recommended that your client’s parents consult with a pediatrician or child psychologist who has experience with this population.  It will also be important to monitor the effects of the medication, to limit the impact of side-effects. Parents are usually the best observers and can provide feedback to prescribing physicians.

■ Speech-language intervention should be provided by an individual who specializes in working with this population, and will likely be most beneficial if it emphasizes sign language rather than solely oral language.  Sign language would capitalize on his/her nonverbal strengths without taxing his/her abilities.  In addition, the broader area of communication should be addressed as a whole (body language, gestures, facial expressions, vocal tone and expression, etc.).

■ Goals for home and school may need to be differentiated. Home should continue to provide a nurturing and supportive social and emotional environment, with emphasis placed on learning life skills rather than teaching more academic subjects.  Home should not become an academic setting for your client.

Additional Strategies Include:

■ Establish predictable routines. Routines should be developed for key parts of the day including: wake-up, washing-up (grooming, self-care), dressing, activities, outings, food, exercise, bedtime, etc.  

■ Use visual or textual schedules (i.e., a written list) that depict the student’s daily routine.

■ Use structured work systems and work schedules (specific number activities of or amount of time to engage in a work task, steps in activity clearly broken down, choice of motivating activity upon completion).

■ Make directions and learning expectations clearly understood. Include essential and concrete information in directions that will answer:  How much work is there to do in this task?
– What exactly am I supposed to do?
– When do I do the work?
– What is my payoff for doing the work?

It will be important for your client and his/her parents to utilize evidence-based practices (i.e., those interventions that researchers have shown to be effective). Information on evidence-based practices for ASD can be found below:

A number of specific suggestions in response to specific stressors:

■ Grooming:  If your client appears to encounter distress during grooming activities, this may be built into their daily routine in small segments.  For example, rather than clipping all of their nails at once, a single finger or toenail could be clipped each day.  Similarly, rather than cutting their hair all at once, a small amount could be done each day.

■ Eating:  If changes are made to your client’s diet, they should be introduced slowly.  For example, additional foods could be added to soup broths in the blender.  Small sections of their food could be coated with new sauces.  A small piece of new food could be introduced in the middle of foods that they eat regularly and enjoys.  Flavours for new foods should be mild (e.g., if introducing fish, Pollock would likely be more successful than a more strongly flavoured fish).

■ Dressing:  When asking your client to help with dressing activities, he/she should be supported initially with hand-over-hand guidance.  A reward should be offered immediately after his/her attempt.  Gradually, he/she can be expected to do things more independently.

■ Drinking from a bottle:  Changing from a bottle to a glass should be done gradually.  Initially, a larger hole could be made in the nipple.  Then the end of the nipple could be clipped off.  Eventually, the nipple could be discarded entirely.  Next, the bottle could be inserted inside a tight fitting glass. Then, the top part of the bottle could be cut off (if it is plastic).  And finally, the bottle could be removed entirely.

■ Visits to physicians/dentists:  Ideally, medical staff should have experience working with this population. Your client should gradually be exposed to the building, office, and professional while doing activities that they enjoy.  For example, the professional could initially come to visit him/her at home or at school. 

They can be taken to visit the parking lot, then the lobby, then the waiting room, and finally the consulting room.  Each time, the visits should be short (5-15 minutes), without any specific medical intervention applied.  This gradual exposure should help to reduce their anxiety about the environment and activities.

For more information on and targeted interventions for ASD, see this handout: ASD Handout