• You should let your child know that he will be returning home again and the
first/then schedule may help with this or you can use a travel schedule
• We all have to do things we do not like but we can make it easier if we plan a fun
activity after the outing. Give him a good reason for going with you. Encourage
your child to look at his schedule, hold it, point to it and help him look ahead to what
comes next.
The main point of using visual communication strategies on outings is to help your child
understand when things start and end. To understand what they might expect and if
they have enough information to help them cope then you may reduce problem
behaviours on outings.
Finally
Behaviour problems are common in young children with autism and while this booklet
provides some practical hints that may help some families, we have to recognise that
many people will require more help than these. It is important to respond appropriately
to aggressive behaviours, self-injury and anything else that you feel you cannot cope
with. If you are finding it difficult to manage, do seek professional help. Contact your
Health Visitor, your GP, your Paediatrician or whoever else you feel most comfortable
with.

Behaviour

There will be no one who has all the answers for you in dealing with the difficult
situations you might experience with your child. While there will be a number of
professionals you can contact, it may be helpful to have some general advice about how
to deal with problem situations, if and when they happen.

It has been our experience that many families share common difficulties. When parents
got together to discuss these it has been useful. There are a number of good
handbooks available but we are attempting to provide some tips for a number of
situations that many of our parents have found helpful already.

Temper Tantrums

When your child has a temper tantrum you need to find the reason for it. When you
know this you can work out the best way of dealing with it. Whether we like it or not
we have to acknowledge that temper tantrums have a purpose.
Your child is letting you know that he is reacting to something he does not like.

OR

Your child is letting you know that he does not understand.

OR

Your child is letting you know that he wants something and is determined to get it.
When you recognise why the child is expressing his feelings through a tantrum you need
to do something about it. Try not to use a great deal of speech and think about how
you will help your child understand what is going on and what he has to do. Use visual
communication strategies eg objects, pictures, line drawings etc to reduce confusion and
help your child understand what he has to do, where he has to go, what his choices are
and help him understand no means no.

When your child is in a full blown tantrum there is no point in trying to negotiate with
him and discuss what is going on. It is necessary to practice walking away from this
situation, saying no firmly, not using too many other words at the time and retreating to
a quieter, calmer environment. IT IS NOT ALWAYS EASY in a busy situation to follow
this advice so we suggest that you practice this at home first or somewhere else, which
is relatively calm or quiet.

There is no magic answer to preventing tantrum behaviour but if your child can
understand what is going on in advance, it will make it much easier for your child to
cope with all the demands of a busy sociable world. Visual communication strategies
will help with this and prevention is always better than cure. You may have to consider
planning activities so that they are structured for success for example

• Only shop on quiet days or when you have somebody to help
• Practice walking past favourite places using your travel schedule and teaching your
  child in small steps that you do not always have to go into this place
• Practice saying 'NO' to your child at times when it is not likely to annoy him but it is
  appropriate. We want him to learn the meaning of 'NO' at a time when he does not
  need to get into a battle with you.
• Home is a very good place for both you and your child to learn that giving
  attention to a tantrum is the wrong thing to do. You need to be able to turn
  your back on the unwanted behaviour and look the other way. If the
  behaviour is impossible to ignore, we need to remove the child to a safe place
  until he has calmed down. Very often this type of attention seeking behaviour
  gets worse before it gets better. Try not to give in even if you are very tired,
  as the end result will be worth the effort.
• It is very difficult for children with autism to cope with our unpredictable world
  so try to plan a strategy in advance if you think there might be a problem,
  then stick to it.
• Try to see the situation through your child's eyes. What might cause a
  problem? Is there something you can change, work around or if necessary
  avoid.

Sleeping

As with everything else it is important to get your child into a proper routine at
bedtime so that everyone can get a good night's sleep. The bedtime routine
should be followed consistently by anyone who would be putting your child to
bed. Your child needs to know that his bed and his bedroom are for sleeping in.
Many children like to play in their bedrooms and often share with brothers or
sisters, however, if sleeping problems occur you may need to think about adding
structure to this part of your child's life.

• Bedtimes need to be regular
• Develop a routine at bedtime that is consistent for example

Bath time
Pyjamas on
Clean teeth
Go to toilet
Kiss goodnight
Into bed
Story time

This routine is only a suggestion, work out your own routine then follow it regularly.

Once your bedtime routine has been followed leave the room. If your child
shouts or starts to cry to try to gain your attention, say 'Night night bedtime' and
ignore his attempts to gain your attention. You must follow the bedtime
routine if you want your child to follow it as well.

• If your child gets out of bed and comes out of his bedroom, you must take
  him back very calmly, do not make a fuss, show him the bedtime picture or
  say 'bedtime', nothing else and put him back to bed.
• Some children will not like this, they may throw tantrums or start wrecking
  their bedrooms. It is important to be consistent with the above routine. As
  with other types of temper tantrums the situation does get worse before it
  gets better, but if you want to change your child's behaviour at bedtime you
  will have to stick to a positive routine.

Obsessions and Rituals

Your child may have some obsessions and repetitive behaviours. These vary and may
include spinning, picking, twirling, jumping, lining up objects, collecting unusual things,
repeatedly watching videos etc. For many children and their families, obsessions are not
a big deal, however, if this type of behaviour becomes disruptive the following tips may

be useful.
Ask yourself
Is this obsession preventing your child from learning new skills?
Is the obsession interfering with family routines?
Is the obsession something you need to change? You may want to think about this.

• Introduce some control to the amount of time the child spends on his particular
  obsession but be realistic. If your child has been bouncing on his bed repeatedly for
  hours on end, it is not realistic to aim to reduce this to minutes as your first step.
• If you could provide your child with other opportunities to play or do other activities
  he really likes, you might be able to reduce the time he has available for his
  obsessions.
• If your child's day is well structured and organised, it will leave him little time to
  become over stimulated by obsessional behaviour.
• Do not try to eliminate an obsession altogether. You want to try to bring this under
  your child's control and we need to teach him that there will be a time and a place
  when he can do his own thing but following the first/then rule.

Children with autism often show obsessions and repetitive behaviours because they
enjoy the sensations or do not have more advanced play skills. Their obsessions often
help them to keep calm in stressful situations. If you are going to try to change your
child's obsessions, you will have to work with him to develop a more acceptable activity.
Be patient.

Waiting

Children with autism often do not understand the concept of waiting and this can be a
problem in a number of situations for example

• Doctors
• Dentists
• Queues in supermarkets, banks etc
• In the car, in a traffic jam or waiting at lights
• Waiting to be served food

We suggest using timer clocks if your child understands the concept of finished. If not,
introduce waiting toys or waiting books. This is a toy or a book that is only used when
the child needs to wait and is put away immediately the waiting time comes to an end.

Outings

Outings can often be difficult for small children with autism and commonly we hear of
how parents struggle with everyday experiences such as:

• Going to the hairdresser
• Buying new shoes
• Shopping trips to busy places
• Doctor and Dental surgeries

Once again parents need to try to think of how their child with autism sees these
outings. Imagine how you would feel if you had to stop one thing and start another,
leave one place to go to another and you were not very sure why. How would you
respond? While some of the children can cope, many just do not understand what is
happening. In this situation we often see resistance to change, tantrum or other
unacceptable behaviours. How does your child see this situation? He may be afraid of
the unknown. There may be a change in the sensory stimulation, different sounds,
smells and feelings. We need to help him understand what is going on.

• Let your child know you will be going somewhere
  Prepare him for a change of activity, even if you don't want to tell him exactly where
  he is going
• Give your child the information he needs to prepare him for what is next. The best
  way to do this is to give him something to carry:
  an Object, which indicates to him what is next
  
  • A travel schedule
  • Shopping lists and/or picture cards
• You should let your child know that he will be returning home again and the
  first/then schedule may help with this or you can use a travel schedule
• We all have to do things we do not like but we can make it easier if we plan a fun
  activity after the outing. Give him a good reason for going with you. Encourage
  your child to look at his schedule, hold it, point to it and help him look ahead to what
  comes next.

The main point of using visual communication strategies on outings is to help your child
understand when things start and end. To understand what they might expect and if
they have enough information to help them cope then you may reduce problem
behaviours on outings.

Finally

Behaviour problems are common in young children with autism and while this booklet
provides some practical hints that may help some families, we have to recognise that
many people will require more help than these. It is important to respond appropriately
to aggressive behaviours, self-injury and anything else that you feel you cannot cope
with. If you are finding it difficult to manage, do seek professional help. Contact your
Health Visitor, your GP, your Paediatrician or whoever else you feel most comfortable
with.