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 and Barbara Weber, M.S., CCC-SLP, BCBA

Table of Contents

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

About the Authors

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

Merle J. Crawford is an occupational therapist with a private practice in central Pennsylvania. She has extensive training in relationship-based interventions and works primarily with infants and toddlers in early intervention, integrating strategies from her varied training when coaching families.

Barbara Weber, M.S., CCC-SLP, BCBA

Barbara Weber is a speech-language pathologist with more than 30 years of experience in school, clinic, and home settings. She focuses on collaborative processes to help families integrate routines-based intervention, particularly with infants and toddlers.

Building Skills to Support Flexibility

The ability to adapt to changes and accommodate across people, experiences, and routines supports regulated responses to daily changes. Cognitive flexibility develops, requiring shifting attention, responding, and inhibiting distractions to attain a goal. Individuals with ASD show difficulty adapting to environmental demands and often exhibit rigid behavior patterns and restricted interests.

Strategies for Incorporating Flexibility into Routines

1. Bath Time

   • Change the time or the bathroom for bath time and vary the order of washing.

2. Bedtime

   • Offer choices of books or songs that differ from the usual routine.

3. Book Time

   • Talk about pictures or read text in varied ways, adjusting question formats.

4. Community Outings

   • Vary routes when going for walks or driving, and change the type of vehicle cart in grocery stores.

5. Diapering and Dressing

   • Change the location where the child gets changed or dressed and vary the order of clothing.

6. Grooming and Hygiene

   • Use different flavors and colors for grooming items to introduce change and variety.

7. Mealtime/Snack Time

   • Introduce new foods gradually with playful activities that involve tactile exploration.

Tips and Hints to Support Flexibility in Routines

• Use preferred items to help children transition to new activities.
• Provide warnings in concrete terms (e.g., "One more slide, then we'll go").
• Utilize distraction techniques during transitions by making them fun (e.g., singing, jumping).

Inflexibility Related to Eating

Inflexibility at mealtime can lead to challenges. Common scenarios involve resistance to changes in food presentation or type. Strategies include:

• Changing the location or presentation of food slowly, maintaining familiarity while introducing variety.
• Using positive reinforcement, such as preferred items or activities, when trying new foods.

Conclusion

Flexibility should be a goal when working with children who exhibit rigid behaviors. Encouraging adaptability through everyday routines can significantly impact the child's ability to cope with transitions and changes.