Kids with strong visual skills but sensory processing issues often forget that something exists once it is out of sight. When we pack up all of their toys when cleaning their room it makes it less likely they will seek those items out to play with.
This was so important to starting a good weekend for my daughter. Weekends are tough because they are off routine. So, I would rotate some special toys into four tubs. One for each weekend of the month. On Saturday morning, I opened the tub and set out the toys on her table in her bedroom. I got her started playing with them. It was like it was a brand new toy. By the following Friday night, after she went to bed, I would pick them up and pack them into the tub. I would then open a new tub for the next morning. She was so excited to see the new toys, she didn’t ask where the old ones were. If there is something they play with often, don’t include that in rotation because it will cause more problems than the benefit of rotating the other toys.
As you go through the month, adjust the items in a given tub with some fun surprises. For example, Sophia loved to peel the stickers off band aids. She loved peeling crayons too. So one time I put a teddy bear in her tub with a band-aid on it and a box of band aids with it. I let her open that entire box and worked with her to put them all over her teddy bear. She absolutely loved it! And as she did it, we laughed and giggled and I kept working to get her to say “boo-boo” and “bear.”
If there is something they love to do, find a way to embrace it into their play and an opportunity for you to work with them on language or fine/gross motor skills. One time, I put a big queen size sheet in the tub for her to play with. We opened it up, threw it over the dining room table and crawled under it to play. She loved playing in tight spaces or under furniture.
Along with your regular toys, here are some other fun items to put in your tubs:
– Sidewalk chalk
– Disposable Camera
– Pots and Pans
– Shaving cream and a cookie sheet
– Roller paint brush and a bucket of water (let them paint your fence with water!)
There are many systems available that you can purchase for a visual schedule and they all have nice features. I found a way to make my own which allowed me to change it depending on what I was trying to accomplish.
The basic supplies you need are:
– Vinyl ID Badge Holders
(Also found at Office Max)
– Ability to print your own color pictures or graphics
Simply stick the self-adhesive magnet to the back of the vinyl badge holder. Now you can insert and replace as many items as you want into your own visual schedule. You can use them on your appliances to set the schedule for the day, use a magnetic dry erase board, or just line them up on a table or place mat.
Notice how for some I used clip art but for “Dinner” I actually took a picture of my daughter at the table sitting on a chair with her family. Using real pictures is very helpful but not always realistic when trying to get a schedule going quickly.
You can keep a box of hundreds of items, people, activities and places ready to go. When you present a schedule to your child try to limit it to no than 6-7 items on the schedule. As you complete, it you can start the next 6-7 activities. By using the schedule you are letting your child process the transitions coming ahead of time. As they develop they may even help you choose items on the schedule.
You can use the magnetic cards for some of the following parts of your day:
- Morning self-care routine
- Play time (Legos, cars, blocks, bath time)
End your schedule with the “big” transition such as moving from play to the bath.
- Big picture for the day
At breakfast, I would lay out a picture of school, who was picking her up from school, anything out of the ordinary, such as a guest coming to the house, etc. Remember the goal is to get them to process these events ahead of time and feel a bit more in control over what will be happening.
- School Work
Many children use visual schedules on their desks at school to help them transition from subject to subject or deal with out of the ordinary events.
- Running Errands
If you know you are going to be in the car and making several stops, put a schedule together of the stops and bring with you. They can help by removing the item as you accomplish it.
- Bed Time Routine
I have also used the cards to help learn to verbalize names of items, make choices, and learn to read. When making your cards, print a simple word for that activity on the card. If they are strong at visual processing, they may learn to site read words instead of sound them out. Either way, they may have the ability to site read words before you even realize it.
One interesting thing I noticed with my daughter at an early age was that when given a choice, she would almost always pick the last choice, even if she wanted the first one. The OT helped me identify this one day. This is why it is so important to become a student of your child. Her processing was such that she could only repeat the last word she heard. As her echolalia became worse, she would repeat the choices instead of answering with one choice. For example, “Do you want juice or milk?” she would either say “milk” or say “juice or milk.” This made communication so very frustrating.
So, to help the situation, I would use the magnetic cards for her choices. I would lay two cards in front of her. One for juice and one for milk. After I asked her the question, she would say “juice or milk” but hand me the card for juice.
My daughter also had a hard time finding something to “play” on her own. I would use the schedule to direct her to several activites. Sometimes I would lay out 5-6 activities and ask her to point to what she wanted to do.
You can also use the cards as a game. Place 10 cards on the table. 5 of them food and 5 of them toys. Mix them up and ask them to put all of the food in one pile and the toys in another pile.
If you are working with them on speaking, work with to say the name of the activity on the card as they complete it and take it off the schedule.
Side note: They may be hard to find, but I used an old 3.5 disk organizer to keep my magnetic cards in. It was the perfect size and came with a clear plastic cover and sections. It is important to store the cards not being used out of site or they will get confused when they see something they want and it’s not on the schedule.
Children with Autism thrive on routine. When Sophia was very young, she hated to brush her teeth and a melt down occurred every time I made her do it. As we started to develop a visual schedule for her daily routines, we added a card for teeth brushing. Like flicking a switch she was now happy to brush her teeth because she was obsessed with checking everything off the schedule in order.
To bring routine to your child’s “care of self” designate an area of their bedroom or some other place in the house for them to complete their routine. It is important to have a mirror accessible to them for self discovery. Below are some items and a sample routine for this area:
1. Child size table and chair
2. Mirror hung at their level
3. Brush and/or comb (barrettes for girls)
5. Lotion for their hands
6. Baby wipes may be a nice addition if you want them to learn to wipe their own face or hands
7. Visual schedule of the self-care routine.
8. Waste basket for tissues.
9. If the area you create is near the bathroom, you can keep their toothbrush there. Otherwise, this should stay near the sink.
To begin incorporating this into your daily routines, bring them to the area each morning and show them the visual schedule. Let them explore the items, including their own face in the mirror. You can make silly faces with them and attempt to get them to mimic. Show them how to put lotion on their hands. Practice blowing their nose. These are all skills that you should be working with them to learn to do independently. It will take time but having a routine and keeping the area the same every day will make this a more comfortable learning environment. Be careful to keep the area clear of anything that does not belong.
Prepositions are a very difficult concept for Autistic children with processing issues to learn. I found this excersie to be the most helpful. It is a montessori language curriculum for preprositions.
When designing a bedroom, more specifically a sleeping space, for your child with Autism or Sensory Integration Disorder, it is important to keep the following tips in mind.
1. CONSIDER ENCLOSURES: Consider a canopy or custom-built bed as an enclosure. It limits the visual stimulation of other things or people in the room and tight spaces give them a sense of security. Custom built captain beds offer the feeling of a cave. If your child enjoys playing under the dining room table or lays under big furniture, this is a clue that they find comfort in this.
2. AVOID BUSY PATTERNS. The only reason I used the striped quilt is because Sophia surprised me and actually asked to have a “rainbow” in her bed. I stuck with solid color sheets and pillow cases. You may also want to avoid trendy bedding such as characters. If they get set on keeping their bedding the same, as they generally do, you could be living with Mickey for many years ahead.
3. GET THEIR PERSPECTIVE. Lay yourself down in their bed and look around from their perspective. What do you see? Is there a lot of clutter, patterns, or something odd like a heating vent? Is there a way to position the bed differently to see less? For example, I intentionally faced Sophia’s bed away from the rest of her room so she was facing the window treatments (soft cream roman shades). I have also avoided having her face the door to her room. This way she does not notice as much of the traffic in the hall going by her door.
4. INVESTIGATE IN WEIGHTED BLANKETS. Weighted blankets are often used to help children with sensory issues sleep better. They are expensive so consider alternatives such as layers of heavy knitted blankets before you purchase one. If you notice a difference, you can find several variations of weighted blankets online.
5. LIGHTING. Keep a light near the bed that they feel comfortable turning on and off. This gives them a sense of control and ability to cope if they feel scared by turning on a light. A wall sconce or even a battery-powered push light can be helpful. Installing a dimmer in the overall lighting of the room helps you control the mood of the room. I would actually suggest putting dimmers in every room in your home.
6. GET A BED TRAY. A bed tray creates a nice option for transition from play to sleep. They can get into bed and yet continue playing or lining up toys on the flat surface of the bed tray.
7. TRY OTHER SLEEPING AIDS: There are several other considerations for this special bed including specialty mattresses, body pillows, and vibrating pillows.
Most importantly, you need to put yourself in their position within the room. For high-functioning children, you can even ask them to lay next to you and tell you what they notice. Ask them what makes noise in their room? Play a game of I Spy with them in their room and see what they notice. As always, become a student of your child!
Next time you are in your kitchen, sit down on the floor and put yourself at the same eye level as your child. Now imagine you are hungry. What do you see? What do you smell? Where are the dishes, snacks, water?
On one hand we desperately want our Autistic child to gain as much independence as possible and on the other hand, we sometimes overlook simple accommodations to help them achieve this. Looking at a room in your house or a daily activity from the eye level perspective of your child will give you ideas for adapting the environment.
Let’s start with the kitchen. Find a cupboard or deep drawer that can be just for them. Place everything they need including dishes, snacks, place mats, silverware, napkins, etc. For safety purposes, give them plastic dishes and glasses. Make sure the cupboard or drawer has a nice large handle so they can easily open and close. You can also store things in this spot for chores they do in the kitchen such as an apron for doing dishes, a cutting board, sponges for cleaning the table, etc.
In the refrigerator, find a special shelf, drawer or spot that has things they use most often. Find mini pitchers for juice or milk that are manageable for them to pour from. A step stool may also be useful if they like to help prepare dinner or want to see what you are doing in the kitchen.
For highly visual children, they often want what they can see. If you have a box of cereal in sight they will want it. Pay attention to what you are tempting them with visually in your kitchen. Set a fruit bowl on your dining room table and bowl with different vegetables in your refrigerator to visually reinforce the foods you do want them to have. If they like a fruit or vegetable, make every effort to have it available.
Below is a list of items that could be included in this special space:
Small plastic bowls
Plastic cereal bowls
Napkins or lower the paper towel holder
Salt or sugar bowl
Plastic storage dishes with snacks
It is important to teach the child to keep this area organized and clean. They should feel free to get their own things to set the table and put them away when they are cleaned.
When my daughter was very young, she would scream and through a full blown temper tantrum right in the water when I attempted to wash her hair. It is worse than trying to keep a cat in a tub of water. Although the biggest improvement for her ability to deal with a bath, and actually now request them, was an anxiety medication, there are several tricks that we learned before that and still use today to keep this a manageable activity.
1. Run the water in the tub before bringing them into the bathroom so they don’t have to hear the water. You may want to start with just a little bit of water and work up over a period of time.
2. Find a mirror that you can put in the tub for self discovery. Mirrors sold for the purpose of high school lockers work because they have suction cups, don’t have sharp edges and are often made of plastic. As they get older, ask them to scrub their own hair with shampoo while watching themselves in the mirror.
3. Find something fun for them to look at on the ceiling above the tub. This will come in handy when you are trying to get them to look up while you rinse their hair.
4. Blow bubbles. We don’t usually think of blowing bubbles as an inside activity, but it makes no mess during a tub and can keep them distracted for enough time to have the other parent quickly wash them.
5. Keep certain toys for the bath tub only. This helps keep a clear reward for taking a bath and can help you convince them to get in the tub willfully. If they like to line things up, find small bath toys that they can line up along the edge or on a bath tray.
6. Get a good bath mat. Be ready to receive their feedback on it and be able to adapt. They may not like the texture so you will need to experiment.
7. For children that are learning to write, use a plastic cutting board and shaving cream to create a tray that they can trace letters on with their fingers. After they write something, smear it again and let them do a different word.
8. Read books to them while they are in the tub.
9. Use scent free soap and shampoo if possible. If you do take them to the store, stop in the shampoo aisle and smell the different shampoos with them. Have fun and laugh, plug your nose at some and see if they have one they like.
10. Most importantly – If you child is anything like mine was early on, don’t take the task on by yourself. Get your spouse, friend or grandparent to help. Put them in and work to clean their hair and body as fast as possible. Don’t take the screaming personal, just work fast and safe with a partner.
11. Put bathtime into a routine and use a visual schedule to prepare them. Sometimes, doing this on a more regular basis is more helpful than procastinating and doing just as needed.
12. When getting out of the tub, wrap them in a large towel and hold them tightly. You might as well brush the hair as soon as possible and get it over with because they won’t like that either and there is no sense for you or them to drag out the experience.
13. Use social stories or children’s books or videos that discuss bath time.
14. Use a reward. Find something that they really love to do (watch a favorite movie, play with a certain toy, video game, etc.) and put the bath just before that on the schedule.
I hope this is helpful and welcome any tips you can share of what worked for you.
If you are looking for activities to add to your morning routine, consider a Pillow Pile.
As you wake up your child, ask them to help you find all of the pillows in the house. This task alone could take a serious amount of time for a child so you will need to adapt based on the skills of your child. Have them carry each pillow to the center of your living room or family room. It should be a large open area not too close to any hard furniture.
After placing the pillows in a large pile, pull up a dining room chair and let them jump into the pillow pile. (The siblings can help too as long as they are not too rough!) When you are done, have your child help you pull all the pillows back to each room.
As you evolve the routine you can adapt to add games like:
- making a path through your house using the pillows
- sorting the pillows by shape or size
- counting how many pillows you find
- if your child is not talking yet, practice words while playing like “jump, again” or “go”
- buy assorted colored pillow cases and ask them to find all the “red” pillows today
- hide pillows from the couch the night before and see how they respond to the pillow not being where they expect it. Ask them to help you look for it.
This activity accomplishes several things:
1. A fun and active morning routine
2. Fun floor play time
3. Heavy lifting
4. Joint compression and proprioceptive feedback
5. Practice for taking turns with siblings or parent
6. Awareness of pillows and their location in the house
7. Possibilities for sorting, learning words, and counting
After a few mornings of this activity, you may find they start collecting the pillows all on their own without you.
Something to Notice:
I would often find my daughter jumping, sometimes even subtly, and think she was being over active or impatient about something. After applying joint compressions to her arms and legs one day, I realized that she was self-coping. Her body needed that impact. Her jumping was giving her body the same feedback that my joint compressions did. Do you notice your child doing an behavior that is giving them feedback? When you learn to notice that behavior you can assist by offering an activity that will help.