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Anxiety

May struggle with sensory input.

 

  1. Environmental Profile – Take notes to figure out what sensory input may be causing them issues and modify the physical environment if appropriate.

  2. Provide a safe space that they can retreat to i.e. a quiet room, tent etc.

  3. Encourage frequent sensory breaks if/when appropriate.

  4. Sensory Profile – Take notes to give a full picture of sensory needs and implement a sensory diet if appropriate.  This can be carried out by an Occupational Therapist.

  5. Share sensory preferences with all settings i.e. home, school, care providers.

  6. Please see Sensory section for further advice.

 

May struggle to understand social situations.

 

  1. Prepare. Explain what will happen, how long it will take, what can be expected, what is expected of them and what others will be doing.

  2. Use Schedules to add structure and predictability through preparation.  This could be a visual schedule, diary, appointment book, mobile phone etc.

  3. Use Social Stories™ that describe a specific social situation that will be coming up.  They will usually include who will be there, what will happen, when it will happen, why it is happening and how it will happen e.g. cinema trip.  They may also include social rules and expectations.  Always check their understanding.

  4. Identify potential issues that may arise such as waiting in line, talking to others, sharing etc and come up with coping techniques together.

  5. Have a back-up plan in case arrangements have to change or there is a wait.

  6. Have an exit plan in case things become overwhelming.

  7. If they become upset listen to them, validate their feelings and explain that you understand.

  8. If they are going somewhere new, you may want to show pictures, videos or visit beforehand so they are more familiar with the environment.

  9. If they are meeting unfamiliar people it may be helpful to build up the time spent around them.  Start off with a few minutes and build this up over time.

  10. Having a bag of familiar items to touch or smell may help them remain calm.

  11. Re-direct to a calming activity or use coping skills.

  12. Social Scripts – These are pre-taught scripts for specific situations.  They may include conversation starters, topics of conversation and responses.  They help reduce stress and are used for a while and then phased out once automatic.

  13. A Social Skills group can help teach conversation skills, how to make friends and socialise, what makes a good friend.  This may include role play.

  14. A Social Skills group can help teach understanding of other people thoughts, feelings and perspectives.  This may include role play.

  15. A Social Skills group can help teach social rules and expectations.

  16. Clarify hidden meanings and interpret what is happening in a situation.  This may include explaining thoughts, feelings and perspectives of others.

  17. If the say/do something inappropriate, give an explanation of why is isn’t appropriate and follow up later if more information is needed.

 

May struggle to understand emotions (their own and other peoples).

 

  1. A Social Skills group can help teach understanding of emotions (body language, facial expressions, anger control and self regulation).  This may include role play.

  2. A Social Skills group can help teach understanding of other people thoughts, feelings and perspectives.  This may include role play.

  3. Label feelings as they happen i.e. ‘you are sad’, ‘you are excited’ ‘I am happy’.  You could also use feelings pictures during this exchange.

  4. Use the ‘Zones of Regulations’ to help them identify their own emotions and coping strategies that they can use to regulate these emotions.

  5. Practice understanding emotions with Emotion Cards Matching Games.

  6. Clarify hidden meanings and interpret what is happening in a situation.  This may include explaining thoughts, feelings and perspectives of others.

  7. Use Social Stories™ that describe a specific social situation.  You can talk through how each person may be feeling in the situation, this may include role play.

  8. Discuss what others may be thinking and feeling as it is happening.

  9. Think out loud, this may help them to understand how you may be feeling.

 

May struggle with change.

 

  1. Prepare. Explain what will happen, how long it will take, what can be expected, what is expected of them and what others will be doing.

  2. Use Social Stories™ that describe a specific social situation that will be coming up.  They will usually include who will be there, what will happen, when it will happen, why it is happening and how it will happen e.g. cinema trip.  They may also include social rules and expectations.  This may include role play.

  3. Use Visual Schedules to add structure and predictability through preparation.  This may also involve sequence strips for tasks.

  4. Break the visual schedule down further into ‘Now’ and ‘Next’.

  5. Use timers/bell/alarm to indicate when a task is over.

  6. Warn before new activities happen.  This may be with vocal warnings, timers, visuals if needed.

  7. Start transitions early so they can do this slowly and have more time to ‘shift gears’.

  8. When difficult transitions happen, give choices as this give them some control i.e. ‘It’s tidy up time, would you like me to help or would you like to do it on your own?’

  9. Explain why the change in task is important i.e. ‘We need to tidy up so we can have lunch’.  You may also focus on upcoming enjoyable tasks ‘After lunch we will be able to play etc’.

  10. Mark any important changes on a calendar (if appropriate).  This way you can count down to any important changes.

  11. If they are going somewhere new, you may want to show pictures, videos or visit beforehand so they are more familiar with the environment.

  12. Show photos of a new person so that they can become familiar with them.

  13. If they are meeting unfamiliar people it may be helpful to build up the time spent around them.  Start off with a few minutes and build this up over time.

  14. Give them extra time to prepare for changes.

  15. If they become upset listen to them, validate their feelings and explain that you understand.

  16. If using a Visual Schedule, have a ‘?’ or ‘surprise’ card for unexpected changes.  Make sure you use this card for positive changes, so that the card is not associated with negative changes only.

  17. Re-direct to a calming activity or use coping skills.

  18. Praise or use rewards when they have coped with a change.

  19. Use praise when they move onto new activities calmly.  If it was a hard transition emphasise that they managed it even though it was hard and they are ok now and they can do it calmly next time.

  20. If they have difficulty with transitions, you could use a reward system when they complete the transition calmly i.e. time with a preferred object, computer time etc.

  21. Having a bag of familiar items to touch or smell may help them remain calm during changes in activities.

 

May struggle with fears and phobias.

 

  1. Figure out the exact fear i.e. if they are scared of restaurants, is it all restaurants?  Is it the smells?  Is it one person who works there?  Is it the fear of eating?

  2. Having a bag of familiar items to touch or smell may help them remain calm.

  3. Use humour (if appropriate), laughter may make the situation less scary.

  4. Help them to relax.  This may be through deep breathing, relaxation, music etc.

  5. Increase exposure gradually i.e. by visiting outside the restaurant, then looking inside when it is quiet etc.

  6. Use role play to act out a fear or phobia to gradually reduce the fear.

  7. If fears/phobias are extreme speak to a GP for advice.

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