Pushing the Boundaries of Routine

There comes a time as parents and carers where we will have to support our autistic child to live in a changing environment that is not always constant and regulated within our control. While children with autism have a fundamental need for routine, it is also important that we push the boundaries of routineness and introduce change from time to time to help our child cope in this ever-changing world.

Pushing the Boundaries of Routine

In A Journey With Brendan, I described how routine had always been at the center of our lives with Brendan since he needed routine to make sense of the world around him. To him, the world we lived in is chaotic and overwhelming. We had routines for getting up and getting ready for school, meals, leaving the house, and bath time and bedtime. All of these routines, schedules, and many more were introduced to Brendan with pictures, social stories, or visual aids gradually over a period of time so as to reduce his anxieties and stress.

Inevitably, sometimes things go wrong despite our greatest effort of planning and preparation. This often occurred with unforeseen events such as bad weather preventing a planned picnic or playground time, and when things did not go to plan, it wasn’t uncommon for Brendan to have a meltdown—displaying severe anxieties and exhibiting aggression and withdrawal. It became clear that as parents we needed to help our child cope with change.

As Brendan developed more confidence with a routine, every now and then we would introduce something new and perhaps comment on it when we were doing a picture board to discuss alternative options. This was a way of encouraging his participation and urging him to accept the concept new elements such as doing things in a different order, bath time before a meal, or having a shower instead of his bath.

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In the beginning, we always implemented routines for any kind of planned outing or trip—creating picture boards to tell him what would happen so that he could understand and be prepared. We did then realize that, as crucial as routine and predictability is to someone with ASD, it is also vital, to occasionally include a little disorder or ‘chaos’, to help them cope when things could potentially not adhear to the plan.

As Brendan developed more confidence and less anxiety with certain situations or trips that he was used to such as skiing or camping, we began to introduce some variation for him, making his world less structured from time to time. For instance, we would take him somewhere unfamiliar without first preparing him by reading him a story about it, or creating a visual board sequence. Alternatively, we would change the plan, in a small way, for what we were going to do on a non-school day. As time has gone on, he’s gotten better at accepting change! And that’s incredibly reassuring.

We haven’t stopped pushing the boundaries for Brendan. We’re determined to give him as many skills and abilities as we could to enable him to connect with others in every way possible. The aim was for Brendan to have vital life-skills in order to navigate the unpredictable world around him, and to manage in whatever situation his future might bring.

There is a need to empower our autistic child to become more flexible and less anxious with unpredictable changes to the environment and therefore able to live a happier life. As a parent, that was all I wanted for Brendan.

Quick Tips

  • Use routines as the mainstay of your child’s day but, over time, as anxieties lessen, introduce change in the routine to allow your child to cope with the change.
  • Initially, give your child several warnings such as visual or verbal cues about what is going to happen, even something as simple as bedtime.
  • Use pictures and social stories to prepare your child for something new or alternative possibilities to an event or outing
  • Don’t be afraid to push the boundaries, if you don’t, how will you know what your child is capable of?
  • Overcome your own fears that change is now possible where it wasn’t before. By practicing change to routine, your child will learnt to cope and be more tolerant of change
  • Set short and long-term goals, be consistent with your approach and be realistic about the time they may take to achieve it.

This article was featured in Issue 102 – Supporting ASD Needs Everyday

May Ng

Professor May Ng, MBBS (Hons), FHEA, FRCPCH, MSc, LLM, PhD is a Consultant Paediatric Endocrinologist and Honorary Associate Professor at the University of Liverpool, United Kingdom. She completed her undergraduate degree under full scholarship at University of Sydney, Australia and her pediatric training in Australia and the United Kingdom. She was the recipient of the prestigious UK Medical Research Council Fellowship and completed further training to obtain a Masters in Medical Science and PhD degree in pediatric endocrinology and diabetes. Dr Ng also holds a Master of Laws degree and is active in medico-legal work. She is Chair of the UK Association of Children’s Diabetes Clinicians, Officer for British Society of Paediatric Endocrinology and Diabetes and Training Advisor for Royal College of Paediatrics. She is in the Diabetes UK Council for Healthcare Professionals and Online Learning Committee for European Society of Paediatric Endocrinology. She is an active researcher with over 150 publications and has presented at more than 150 scientific meetings. She serves on the editorial board for several international journals including as Editor-in-Chief and as Associate Editor and is a regular invited referee for many high impact journals. She is a clinical lead of multiple national award-winning initiatives such as University of Liverpool Alumni Award 2020, Diabetes UK Mary Mackinnon Award 2018, winner of 2015 Diabetes Quality in Care award, Highly Commended runner up for Diabetes Team of the Year National BMJ Awards 2015, finalist for the HSJ Clinical Leader of the year 2015 and finalist in the UK Asian Woman of Achievement Award 2016. She is also a book author of ‘A Journey with Brendan’ documenting life with her son with autism as both a mother and pediatrician. For more information visit my website. Twitter @mayng888.

  • Avatar Cheryl Moore says:

    Where can I get a daily routine chart that will work for my 6 year old? We need to set some routines up like getting up, brushing teeth, etc.

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