Thursday, November 26, 2009

Holidays with Autism

Holidays with autistic children can be rough. Anyone who's taken their screaming child out of a crowded family dinner, or avoided one entirely, knows this.

For those of us who work with autism, or have a relative with the diagnosis, knowing how to help can save a holiday get-together. And if you live with a child with autism, being able to control or avoid the worrisome meltdowns will make your holidays a little more cheerful.

The first tip, of course, is to know your child. If he/she doesn't do crowds, don't force them to come along to a large gathering. Invite a few family members or friends over at a different time, or arrange child care (there are babysitters who have the skills and experience to care for your child, though they may be hard to find) so that you can enjoy your family gathering.

If your child is ok with family members but can't handle a whole evening, ensure a quiet and calming place for him/her to go. Remember not to leave your child unsupervised in a strange place (this goes for all kids, autism or no), but also remember that other family members are there to help - and if you are that other family member, don't hesitate to step in and sit with the child for a while. Parents need a break sometimes, and having a supportive family can be the best holiday gift.

Preparing a child for the holidays is also a great way to reduce meltdowns. Practice greetings and read stories (social stories or children's books) about the holiday. Discuss expected behavior with both the child and the relatives. If a child is touch sensitive, remind relatives in advance so Aunt Sarah doesn't attempt her infamous bear hug. If they enjoy certain kinds of touch, like tickling or tight squeezes, tell relatives this as well. Arriving early is a good idea. Prepare foods for your child in advance or give recipes to the cook. If your child likes new foods it's ok to introduce one or two but now is not the time to be pushing a plate of ham and peas at a child who eats only chicken nuggets.

Be sure to provide your child with something to do at the gathering, too. Many children with autism do not play by themselves and even though children seem to enjoy self-stimulating behavior (rocking, flicking, head-banging, staring, squinting, and a host of other behaviors), it may actually be a habit that they can not break and no longer enjoy. It's better to prompt them through a couple of games with lots of praise and favorite treats than to assume they are having "fun" on their own. Even a fidget toy is a better alternative than nothing.

Which brings us to gifts: sometimes, buying the right gift for a person with autism is awkward. If you're buying, ask for suggestions. Sometimes a family could use autism-related materials like special clothing, toys or sensory devices. Other times, they may just want clothing made out of materials that won't irritate the child's skin. As a relative, don't insist on buying a gift that the child can't enjoy because "it's what normal kids play with", and avoid gimmicks related to "fixing" autism - they don't work, and they're insulting. As a parent, you can make it easier by developing a list far in advance, and updating with appropriate clothing sizes and a developmental range for toys as the holidays approach. Children may not have the skills (attention span, fine motor, ability to take turns, etc) to enjoy a toy aimed at their typical peers, so choose based on a developmental level, rather than age. That's not to say you can't buy a game that the child will need to work at, but be mindful of the challenge. And be mindful too of the child's ability to open gifts - you may want to simply use gift bags, or expect adults to do the unwrapping.

Not all kids will enjoy or even manage family gatherings. Never feel guilty if you know your child can't handle the holidays the way your relatives wish he could, and do not apologize for your child. Simply work on it for next year, with small steps, including giving the relatives plenty of warning.

If you are a relative, your main goal for a happy and relaxing holiday should be to educate yourself. Don't expect a child with autism to be a perfect guest even if he is high-functioning and generally well-behaved at home. Ask the parents or caregivers about triggers - things that may set a child off. Do your best to reduce them or provide a space without them. Have parents teach you how to deal with problem behaviors, and inform other family members so that you present a united front (this is good advice anyway; kids love to play adults off each other in order to get away with bad behaviors). Make sure there is food that the child can eat, or ask the parents to provide it. Inform any children coming that the autistic child is not "stupid" or "bad", but simply learns differently, and needs more patience to play with. And remember that rule yourself.

Don't exclude a family member with autism, or his/her parents, because you think it will be a "headache" or "too much work". By doing so, you are doing more than hurting feelings. You are denying family members the ability to enjoy the holidays the same way you do, and denying yourself the opportunity to get to know your autistic relative a little better, and provide a wide support network to help him/her improve. No child can improve his or her behavior without support from adults; why neglect the child who needs the most support of all?

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