Expert: Dr. Sharon A. Mitchell - 11/8/2010

Question
A 10 year old girl with autism expresses fear, anxiety and some restlessness by scratching herself, weeping, rolling on floor whenever the lights go off suddenly. if she is asked to switch off the lights on her won she would do it happily but if the lights go off "suddenly" she becomes restless. what should i do in order to help her cope with this. she is not a very expressive child who could share her concerns. there is no childhood history or association of such events. please help.  

Answer
It's difficult, isn't it, when a child is unable to tell us what is going on in her mind. We then have to play detective to seek out what may be behind the behavior we see.

At least you have related her behavior to the lights and you've already discovered that it not necessary the lights being off, but when they are turned off unexpectedly. It must be distressing for those around her to see this little girl so upset.

Given her expressive language difficulties, it may be difficult to discover what started this fear. Her family may be able to provide some clues but sometimes children with autism make associations that are not apparent to other people.

It is common in autism for there to be sensory sensitivities. These sensitivities may alter over time. For example, a child may be very tactile defensive, disliking the feel of some clothing, avoiding light touch, etc., then this sensitivity may decrease but be replaced by another sensory difficulty. Perhaps your child has become sensitive to light or the absence of light. Perhaps something happened to her in the dark - something no one else notices or would relate to the lights being off.

Sometimes desensitizing a child to the fear may help. You've already started down that road by having her turn off lights on her own. Is she able to do that in a number of different rooms, at different times and with different people? Is she able to tolerate being in the dark for varying amounts of time? With various people?

What does she really like? Is this something you can offer her when the lights go off? Or as a treat when the lights return as a reward for waiting it out until the lights go back on?

There are strategies you can try that may help desensitize this little girl or that may help her tolerate the dark without becoming so very anxious. Weights help many children to feel calmer or more grounded. You could try a weighted vest. Exercise ankle weights (the kind that you would attach with velcro around your ankle or wrist) are worth trying. Some children like them draped over their shoulders or lain across their lap; others like them around their ankles. You can also purchase ready-made lap weights.

Other children can be soothed through deep pressure. Their are spandex or other types of vests or shirts that apply a feeling of tightness to the torso. Here is an example of one: http://www.southpawenterprises.com/%2FBear-Hugs-P837.aspx

If you have access to the services of an occupational therapist, this professional could help you discover the sensory profile of your child and suggest other strategies to try.

Kids with autism do not automatically take their cues from those around them. This little girl may not even notice that other children do not react in the same fashion as she when the lights are suddenly turned off.

Social stories may be an effective way of teaching her other ways to handle her anxiety and other strategies of what to do when she's surprised when the lights go out. There are many books on social stories; here is one: http://tinyurl.com/23fk5lb If you are unfamiliar with the concept of using social stories, glance through this explanation and examples: http://www.polyxo.com/socialstories/introduction.html

Here's a very simple visual about calming down: http://www.speakingofspeech.com/uploads/calmdown.pdf Visuals are a wonderful tool to use with kids with low language. The following website is full of great information on visuals, plus free pictures and games: www.do2learn.com.

Best wishes as you work with this little girl,

Dr. Sharon A. Mitchell