Expert: Catherine Ridenour - 4/29/2011

Question
my 4 year old son was recently diagnosed with autism spectrum disorder, he has great language skills it seems mostly social.  i am curious if agoraphobia would go along with this he doesn't really like to leave the house to go to dinner shopping,walking to bus stop.  he does go to preschool but it is a challenge to get him there.

Answer
Hi Dawn,

Reluctance to leave home is probably linked to his comfort with the familiar surroundings and routine. This is not classic agoraphobia but it can become like it if he is allowed to "hide out." Most people on spectrum are upset by sudden noises, unfamiliar situations and changes in routine. Nevertheless, getting out is crucial to his development. Keep going places with him.

Pay attention to his reactions to the environment and see if you can pick up on what he dislikes. Don't point it out to him, just work on making it more familiar. If he's afraid of buses, for instance, read "Magic School Bus" books to him.

Also, check out "social stories". These simple stories address one particular situation at a time, using your son as the main character. "Jimmy Goes to the Grocery Store" for example. The story should talk about getting ready to go, what is done at the store (Jimmy helps Mom pick out cereal for breakfast. He puts it in the cart....), and coming home again. You can purchase these or make your own with stick figures or cut out pictures from magazines. Let him help you make up the story. Then, read it with him several times. Keep it short and simple. Make a new one for each situation.

Starting now to enforce the boundaries (we get to school on time) will pay big dividends when he is older. Establish routines that help this happen but don't make them too rigid. A simple chart of the steps to getting ready is helpful. Start with a wide awake picture, then one of clothing, then one of a plate and spoon to represent breakfast, then one of his toothbrush, then his coat. You can put simple words beside the pictures to help him learn to read. You get the idea. He will feel empowered by this. He can see what comes next and initiate the process, eventually, rather than you having to remind him.

Despite his diagnosis, foster as much independence as you can. The key to these kids, in my opinion, is realizing that he may be smarter than his physical age but much younger, emotionally. Ask for age appropriate behavior but be prepared for an immature response. It's okay to make mistakes, guide him with what to do "next time" rather than dwelling on the error.

He must learn each new situation, he will not generalize information. Over time, he will build up a library of appropriate responses to a wider variety of situations. Still, a new wrinkle can throw him for a loop. It's part of the package.

Here is a link where you can see a social story : <http://www.polyxo.com/> free teaching resources for parents and teachers, social stories, etc.

Best wishes,
Catherine