The need for predictability and adapting to change can be difficult for some young people with neurodevelopmental profiles and not everyone will react in the same way. For some, change can bring about anxiety, for others frustration and for others ‘meltdowns’. Some young people can be resistant to the smallest of changes to their everyday routines and others can manage some changes but not others. Everyone is different. Below are some of the ways you can help:
These can be made using photographs of real objects, symbols or cartoon pictures. Their purpose is to break down time into simple steps, showing what is going to happen and in what order.
This could be as simple as a first/ then board.
A schedule could represent a sequence of different activities for part of or even all of the day. It is important to try not to do too much all at once e.g. seeing the whole day might be too overwhelming for some children/young people. Try to make sure that the visuals that you use are appropriate to the young person’s needs. You can find examples of visual schedules here.
Visuals schedules can also be used to reinforce every day routines e.g. getting dressed, brushing teeth, bedtime etc.
For some young people a bullet point list will be enough to remind them of what is going to happen. For others, simply talking through the plan for the day will be enough to help them feel calm/understand what is going to happen.
For young people in secondary school it can be helpful to ask for a visual timetable from school to help make the school day more predictable.
Try to always set out the plan for what is going to happen before you go anywhere, keeping your language clear and simple.
Some young people need more time to adjust to changes so try not to announce ‘last minute’ changes if you can and make sure that you allow extra time for them to process what you have said.
Acknowledge the young person’s feelings about the change (e.g. frustration, anger or anxiety) and explain the reason why, as this may not be obvious to them at the time.
Sometimes young people may resist going to new or different places if they cannot predict what is going to happen. New can feel scary. If you are going somewhere new, try to imagine you have never been there before. What information would be helpful to you? How could you provide this information to your child or young person in a way that might make sense to them?
For some children and young people, Carol Gray Social Stories can be very helpful in preparing for change. There are many published social stories that you can access and where appropriate adapt, to make them specific to your child and the situation.
Social stories can be made up of pictures and words and can be used to help prepare for new situations or things that do not happen very regularly e.g. what to expect when going to a birthday party, going on a school trip, having your feet measured, what will happen at the summer fair etc.
Their purpose is to provide factual information to the young person, to describe an event or sometimes give reasons why things happen – all of which help to make the situation more predictable for the young person.
Sometimes children and young people can find it difficult to stop doing something that they like. Using visual ways of breaking down time can be helpful to make it clear when an activity needs to come to an end.
Often if a young person is engaged in an activity they like, then they may not process verbal reminders to stop e.g. saying “five minutes left” may not be helpful, unless that five minutes is also represented visually so they can see how long is left. The following can be helpful:
Sometimes an activity or object is unavailable. For example this could be that the park is closed for a while or perhaps you have run out of your child’s usual snack. This can be tricky for some young people to remember and understand.
Visuals can be helpful for supporting young people to know that something is not available right now. Pictures are easier to remember than words and can be used to reinforce what you are saying.
Sometimes despite our best efforts, things change at the last minute. These unexpected changes can be really difficult for some young people to cope with. It can be helpful to have some strategies up your sleeve to support your young person if things change unexpectedly.
Preparing for unexpected changes can help your young person to cope when plans have to change. A good way to do this is by including an unexpected change symbol as part of their visual schedule.
For example, if you use a visual schedule of activities for your child, you could leave a gap between two of the pictures to allow another picture to be put in later. You could use a ‘question mark’ to represent a ‘mystery’ or uncertainty. If your child has a written schedule, you could leave one blank line between two of the tasks. In the gap do something which the young person really enjoys, it could be their favourite snack or maybe a trip to the park. By gradually introducing an unexpected change symbol the young person can learn to cope with pleasant changes. This then helps them to manage less pleasant changes better.
For example: using a ‘change card’ on your child’s schedule.
Once your child is familiar with the ‘?’, you can use it anytime there’s an unexpected change to show there’ll be a diversion from the schedule and then a return.