Expert: Dr. Sharon A. Mitchell - 7/9/2010

Question
My son is seven years old and on an IEP. He has received services since kindergarten. His father and I recently separated and the stress  has had an impact where we feel his communication skills are regressing. I am deeply concerned my son will "shut down" as I call it again and I have no clue what to do. Any and all advice on where to find help would be appreciated.

Answer
Parenting any child is not easy but it's especially difficult with a child with special needs and a shared situation. Your son is lucky that his parents obviously still communicate and come together for his sake, since you mention that WE feel his communication skills are regressing.

Routines and stability are so important particularly for a child on the autism spectrum. Unfortunately, there are few of us who get to be in situations where we can control the routines and stability. Life just doesn't work like that. Learning to adapt to change is an important skill but a difficult one for kids with autism. There are things you can do to help, though.

When you have difficulty making sense of the world around, know what comes next and what is expected of you, routines are something to fall back on to make life predictable. Even though your son's situation is changeable, there are ways to create more stability for him.

I think some of his current distress is because he does not know where he's going, who he'll be with and what will be expected of him there. He was used to having two parents in his home and now he has one (or one at a time).

Receptive and expressive language skills can be difficult for kids with autism spectrum disorders and also for other kids. For you son,this means that he neither understands well what he hears, nor can he express his own feelings well with words. Not being able to get your needs and wants across causes frustration that often comes out in tantrums and other undesired behaviors in little ones. Your son is probably just as frustrated by his difficulties in comprehending what is said to him.

He may understand some of your words simply due to repetition and being used to a certain routine. You may unconsciously be coupling your words and directions with motions that back up your meaning, such as holding out his coat to him while you tell him to put on his coat. He may be responding more to the image of his coat than to your actual words.

This is why we use visuals with kids with autism spectrum disorders. It is easier for him to get meaning out of something that he sees as opposed to something he hears.

The first thing I would suggest you do is create a visual schedule. You might keep one on your fridge and another in your purse to show him whenever needed. Possibly a third copy could be kept at the day care for staff to go over with him when he seems anxious. This visual schedule is rather like a calendar. There are a couple ways to do this.

You could have a weekly schedule. Along the left side of the page could be the days of the week and along the top a picture of your house or your husband's place to show your son where he will spend that night. Perhaps a picture of his bed and toys he keeps in each bedroom would be better or a picture of you or your ex-husband.

Another way to do this might be to make a daily schedule.  Each morning show him the appropriate schedule. For instance when he's with you, his day's schedule might consist of a series of pictures in a strip, such as:

- boy eating breakfast
- boy washing his face
- boy brushing his teeth
- boy getting dressed
- boy and his mom getting in the car or bus
- picture of the day care center
- picture of his mom (or dad) picking him up
- picture of eating supper at his mom (or dad's) house
- picture of playing
- picture of going to bed (at whichever house)

Another way to do it is to have one schedule with the pictures paper clipped or velcroed on. Just stick on the pictures that go with what is planned for that day. Using schedules such as this will let your little guy know where he'll be and who he'll be with, decreasing some of the anxiety the not-knowing causes. Plus, it will reduce your reliance on language to let him know what's going on.

You can further break down visuals to help him. For instance, on his bedroom wall have pictures of the order in which he should put on his clothes. Also in the bedroom you could put picture labels on his shelves and containers and drawers to he knows where the put things away. In the bathroom you could have pictures of what he's to do there, such as use the toilet, wash his hands, wash his face, brush his teeth. In the kitchen, a picture could show him where to put things when he sets the table and other pictures could show him what he needs to do to get a bowl of cereal for himself. Yet another visual could show him which things to put in a suitcase to between his two homes.

The same visual schedule system could be used at day care (and is in fact used commonly in schools). Using visuals may decrease your son's anxiety at day care and therefore his aggressive incidents. A great website to look at is www.do2learn.com. They offer free pictures there, plus grids to use for your schedules plus they explain in more details the hows and whys of using visuals.

Does your son see a speech therapist? If so ask for her help and advice with visuals and social stories. Since he is 3, have you had any involvement yet with your school district. On an early entrance basis, many schools will offer advice and services.

I would suggest that you consistently use these visuals for a month. It would be ideal if your son's father would also use them but even if it's just you, that is still a big help.

Even children who have special needs and an IEP are more resilient than you might think. He needs love and security and stability; that might come from two parents living in separate residences.

Best wishes,

Sharon A. Mitchell, B.A., B.Ed., M.A., PhD candidate