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Managing Change

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:

Visual schedules

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.

Time to process

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.

Visits to new places

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?

  • Holidays – google the hotel, talk through what will happen at the airport, how you will get there, how long it might take etc.
  • Medical appointments – speak to the service beforehand so that you know what to expect. Some services may already have helpful leaflets you can show your young person. Talk through their worries with them and answer any questions they may have.
  • Moving house – visit the house with your child before you move in so they can have a look around and picture where they will be sleeping etc.
  • Moving school – speak to school to ensure that appropriate transition plans are put in place and that your child has extra visits if needed, meets key staff and starts to get to know the layout of the school beforehand.

Social stories

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.

Switching between activities

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:

  • Count down to stop rather than simply saying an activity is finished.
  • Try to support ‘how much longer’ in a visual way e.g. egg timer, stop watch, timer on your phone to clearly show how much time is left.
  • If the activity is part of a daily routine, then try and make the time allowed as predictable as possible.
  • Keep your language clear and simple and repeat the same message e.g. “when the timer rings, then it’s time to go”.

When activities are unavailable

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. 

Managing unexpected change

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.

  • Go on an outing and place a ‘?’ on the schedule. Make sure something fun happens when it’s time to do the ‘?’ on the schedule. Praise your child for coping with the unknown. This will help your child to learn that something unexpected can be a fun thing.
  • Go on an outing without the ‘?’ on the schedule. At some point slip the ‘?’ into a gap on the schedule. Immediately bring out the fun surprise and praise your child for coping with an unexpected change.
  • Go on an outing without the ‘?’ on the schedule. At some point make an unplanned diversion – for example, a sibling wants to look at the pet shop, and it’s not on the schedule. Add in the ‘?’, reward your child for coping, then quickly get back to the schedule.
  • Go on an outing without the ‘?’ on the schedule. Make an unplanned diversion that your child usually doesn’t enjoy – for example, visiting one extra shop. Show this by placing the ‘?’ in an appropriate gap in the schedule. When completed, reward your child for coping, and then return to the usual events.

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.

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