For working with children birth to 3 with red flags for autism

Embedding Activities in Daily Routines for Young Children and Their Families

Every Day!

Autism Intervention Every Day! Embedding Activities in Daily Routines for Young Children and Their Families

by Merle J. Crawford, M.S., OTR/L, BCBA, CIMI

Contents

1. Autism and Early Intervention.....1
2. Supporting Parents from Suspicions to Diagnosis to Services .....9
3. Principles of Behavior and Teaching Strategies.....19
4. Model for Addressing the Core Deficits of Autism .....31
5. Building Skills to Support Regulation.....39
6. Building Skills to Support Making Sense of Self, Others, and the Environment.....53
7. Building Skills to Support Flexibility.....77
8. Building Skills to Support Social Communication.....85
9. Daily Routines and Common Challenges.....107

Building Skills to Support Flexibility

Building Skills to Support Flexibility

The ability to adapt to changes and to accommodate and assimilate across people, experiences, and routines supports regulated responses to typical changes that occur on a daily basis. Infants and toddlers must adapt to changes as they interact with multiple caregivers, as they participate in routines, and as their bodies change and skills develop. In addition, cognitive flexibility develops, which requires shifting attention, responding, holding information in the mind, and inhibiting other distractions and other responses in order to attain a goal.

How to Incorporate into Routines

Some children with ASD are quite flexible, whereas others are not. The following strategies are ideas for incorporating changes into routines that can be implemented gradually and playfully to aid in promoting flexibility for children who tend to be rigid. Implementing too many changes at once would likely overwhelm both the child and the caregiver.

Bath Time

• When convenient and practical, have bath time at a different time of day or in a different bathroom.
• Give the child a choice whereby both choices are different from the usual routine, e.g., wash hands or ears first.
• Use a variety of colors of towels and washcloths.

Book Time

• Sometimes talk about the pictures and sometimes read the text.
• Vary the questions asked about the pictures or the story to increase engagement.

Bedtime

• Give the child a choice of two books to read or two songs to sing.
• Vary the closure when leaving the room (e.g., “Sleep tight,” “See you in the morning”).

Community Outings

• Vary the route when going for walks.
• Change the location of the child’s safety seat in the car occasionally.

Diapering and Dressing

• Vary where the child’s diaper is changed and where the child is dressed.

Grooming and Hygiene

• Change the timing of when to replace items such as toothbrushes, toothpaste, and soap to help foster flexibility.

Household Activities

• Modeling flexibility during household chores can demonstrate that changes in routines can be beneficial.

Playtime

• Use preferred items to help children transition from one activity to another.
• Focus on what the child will do next rather than what they are leaving behind.

Inflexibility Related to Eating

• Discuss scenarios illustrating challenges young children face related to food selectivity and resistance to routine changes.

Tips and Hints for Inflexibility Related to Eating

• Change the location of the child’s highchair or give playful food choices to engage the child.
• Use playtime to expose picky eaters to new foods in less stressful settings.
• Vary the presentation of foods that are already in the child’s repertoire (e.g., cut sandwiches in different shapes).

Ideas for Monitoring Progress

• Make a list of ways the child adapted to variations.