Every year, cold weather brings two big challenges for our teen, who has autism: the transition to heavier clothes and understanding the danger of cold weather. When he sees snow, he wants to run outside. Advice?
Today’s “Got Questions?” answer is by psychologist Stephanie Weber, of the Kelly O’Leary Center for Autism Spectrum Disorders at Cincinnati Children’s Hospital Medical Center. The center and hospital are part of the Autism Speaks Autism Treatment Network (ATN).
Editor’s note: The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.
The cold weather sure came on quickly in many parts of the country this year. This can intensify the challenges you describe – challenges shared by many families affected by autism.
So let’s start with your first question. The seasonal change to heavier clothing commonly poses difficulties for those who have sensory sensitivities. Your son may prefer the lighter touch of summer clothing. So it may help to start with putting that summer clothing away and out of sight. If your son asks where it has gone, consider simply stating, “It’s not available until the weather is warm again.”
Selecting some motivators
Next, we want to help your son put on that coat and keep it on. Let’s start by identifying a reward to help motivate him. Given the time of year, perhaps he’s really into Christmas cartoons, or maybe candy canes. You can provide these rewards for each small success, or use a token or sticker board to earn “points” toward a reward. You know your son best. Use that understanding to gauge how much or little of the reinforcement you need to keep him motivated.
Mastering the coat
Now, you’re ready to help your son begin practicing with that coat. A timer can help you both with the task of keeping the coat on for increasing periods. This can be an audible timer that beeps or rings, or a visual one such as a digital clock. Depending on his level of resistance, you might want to start with as little as 5 seconds in the coat. I suggest beginning by increasing the time in the coat by 5 to 10 seconds with each early success. Using your judgment, you can try increasing the time increments by 15 to 30 seconds with subsequent successes.
If getting into the whole coat is too much for starters, try one arm in the coat for 5 seconds. Work up to putting the whole coat on for 5 seconds, before increasing the time with the whole coat.
It’s important to start wherever your child is ready. Continue to build on each of his successes with those positive reinforcements – be they stickers, small pieces of candy cane or short cartoon breaks.
Introducing the new routine
Of course, your goal is to have your son put on his coat before going outside in cold weather. Perhaps this will need to become part of his morning routine before leaving for school. As with other changes in routine, it helps to start the transition with advance “warning” followed by repetition of the new steps involved.
I find this to be true with any big transition – be it moving to a new school or putting on a heavier coat. So, when possible, I encourage families to allow time for practice steps leading up to the new expectation. For some children, it helps to begin talking about the change days or weeks in advance. Other children do not do well with warnings too far in advance. You may consider only a week or a few days of talking about the changes with your son.
In either case, I suggest explaining the reason for the change in simple terms. For example, “It’s cold outside. We need to wear our coats,” or “Wearing shorts is done. It’s time to wear long pants.”
If your child can read, you can write these reminders and leave them up in your home. Many individuals affected by autism respond best to visual supports. I find this to be true even for those who have excellent receptive language skills. (Receptive language refers to the ability to understand what others are saying.) There’s something about writing down expectations and/or illustrating them with pictures that makes them more concrete for many people with autism.
Creating a visual schedule
So once your son has mastered putting on the coat and keeping it on, consider adding this new step to a visual or written schedule. In the example below, we’ve added a picture for “Put on coat” between “Put on shoes” and “Leave for school.”
This may feel excessive if your son has already mastered getting ready for school. But I’ve found that returning to step-by-step instructions – if only temporarily – can help a child or adult with autism master a big change such as dressing for winter weather. Use this visual support as long as needed. Then, gradually remove it from your son’s routine.
For more information on using visual supports, see “Visual Supports and Autism Spectrum Disorder,” an Autism Speaks ATN/AIR-P tool kit. Follow the link for free download.
Introduce a mantra
Another strategy I often use to help children master a change in routine is to have parents and other caregivers use a “mantra.” In this case, it might consist of two short phrases such as, “The weather is cold. We wear our coats outside.” With consistent repetition, this may help your son not only understand your expectation but also make the connection to protection from the cold.
Taking this idea a step further, many caregivers and therapists use social stories to help an individuals with autism understand expectations. In this case, you might take a picture of your child’s coat and other cold-weather clothing. Also take a picture outside your home. Then, write short sentences (based on your child’s level of understanding) that outline the “first-then” steps in this story.
Winter is here. It’s cold.
I need to put on my long pants,
and long-sleeved shirt,
and my coat
before I can go outside.
(Picture of the front of your house)
You might add the positive reinforcement of a reward to this story, as in:
First, I put on my winter clothes, then I earn extra play time!
(Picture of your child’s favorite toy or activity)
For more, see “Social Stories: Their Uses and Benefits.”
Explaining cold-weather dangers
Advice on helping your son understand the dangers of cold weather will depend on his developmental level. With some children it helps to develop or read stories that include descriptions of extreme weather and people taking shelter from it.
For other individuals, stressing “understanding” isn’t appropriate or useful. In these cases, it works best to keep the focus on expectations and rewards or consequences. For example, you want to make clear that he is not allowed to go outside if his coat is not on. If he is playing outside and takes his coat off, you need to promptly direct him back inside until he puts the coat back on. The mantra and visual supports described above can help you keep this simple and straightforward.
Indulging the need to be outdoors
Many children who love being outside have difficulty when cold or stormy weather confines them indoors. If this is true of your son, consider alternating relatively short periods playing outside with “warm up” breaks indoors. For example, you could use a visual schedule to let your son know that he can play outside for 10 minutes, then come inside for 10 minutes before returning outside for another 10 minutes.
I recommend some sort of positive reinforcement to encourage transitions from a favorite activity such as being outside to a less-preferred activity such as coming indoors. For example, begin the transition indoors with something you know your son will enjoy. That might be a short game with you rather than, say, bath time or homework.
Thinking ahead to next year
Finally, consider making a note on next year’s calendar – on a date before the cold weather really hits – to remind yourself to let your son know that the time for heavier clothing and a coat is coming.
Thanks again for your question. Please let us know how these strategies work for you and your child.
Got more questions? Send them to firstname.lastname@example.org