Establishing a predictable and structured daily schedule for your child with Autism Spectrum Disorder (ASD) can make a huge difference in her ability to meet behavioral expectations throughout the day. Unexpected changes in schedule may be upsetting and trigger challenging behavior that impacts the whole family. Follow these simple steps to create a thoughtful daily schedule:
1. Review your child’s daily activities: Begin by writing out your child’s activities on a typical day. Make note of the activities that are associated with challenging behaviors and focus on those activities first.
2. Choose prevention strategies that make sense for you and your child: Consider whether any of the following strategies could be used to prevent problem behavior from occurring.
• Reorder activities: Sometimes children engage in their most naughty behavior when they are asked to stop a favorite activity and transition to a nonpreferred activity. For example, a child might scream and protest when his father asks him to turn off the TV and begin homework. To prevent challenging behaviors that arise during these difficult transitions, simply reorder the activities (i.e., ask him to complete his homework and then offer TV time as a reward).
• Provide warnings: To reduce challenging behaviors associated with transitions, use visual and auditory cues to remind the child about the upcoming change in activities. Setting a timer that signals the end of activity at the 10-, 5-, and 2-minute mark—or simply stating the remaining number of minutes left in the activity—will prepare them for the end of the activity.
• Change the timing of activities: Children may engage in challenging behavior when they are asked to do a difficult task in a short amount of time. If your child engages in disruptive behavior when he is asked to quickly pick out his clothes in the morning, have him complete this activity at the end of the day, when he has more time and there is less pressure to get out the door and catch the school bus.
• Modify the environment: Children sometimes become more distractible when tasked with activities that require sustained mental effort, such as homework or practicing an instrument. Help minimize distractions for your child by creating a distraction-free zone for activities that require continued attention (e.g., provide a quiet work space away from siblings, give your child special headphones, remove technology from the room).
• Build in breaks: If your child engages in problem behavior or is very active when asked to sit down and complete schoolwork, schedule short breaks for her in advance. For example, after completing 10 math problems or engaging in 15 minutes of homework, provide your child with a 2 minute break. During breaks, encourage your child to do something relaxing, like look at a book, or release energy through short exercises or games, such as jumping jacks or a quick round of Simon Says.
• Establish routines: Creating daily routines for activities that are associated with challenging behaviors may help increase compliance and independence with daily living skills. For example, many children demonstrate behavioral difficulties surrounding bedtime; establishing a bedtime routine that incorporates 4-6 steps, which may be completed in the same sequence each night (starting with the more demanding and ending with the more enjoyable), will help your child learn the expected and appropriate behaviors.
3. Set up a visual schedule: After you have developed the schedule of activities for your child, you can create a visual schedule with basic art supplies (e.g., foam board, markers, and Velcro) or on the computer that may be shared with him. Visual schedules promote predictability and increase comfort and independence with daily activities. You can draw pictures of the activities, take photos, or find images online—incorporating simple pictures into the schedule may increase your child’s understanding of the behavioral expectations and the appropriate sequence of activities. Print the pictures, laminate them, and apply Velcro to the backs so they can be placed on the board.
4. Introduce the schedule to your child: Decorating the schedule with your child can be a fun way to introduce the idea. Gather some art supplies that she enjoys and encourage her to make the schedule her own.
5. Post your schedule in a high traffic area: To maximize the impact of the schedule, find it a good home! Posting the schedule in a place where you and your child spend time regularly, such as the kitchen or his bedroom, will facilitate greater exposure. Be sure that the schedule is at his eye level so he can reference it with ease throughout the day.
Rebecca Shalev, PhD, BCBA, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.
At Hassenfeld Children’s Hospital at NYU Langone, we understand that caring for infants, children, and teenagers is a special privilege. That’s why we partner with our young patients and their families to offer expert medical and surgical care. Our specialists treat children with conditions ranging from minor illnesses to complex, more serious issues at locations throughout the New York metropolitan area.