One of the key principles of occupational therapy is developing strategies to support people in areas where their diagnosis can interfere with daily living. This varies depending on the condition, but the most common approach for autistic people is developing regulation strategies to prevent or manage anxiety.
It’s important to stress that autistic people have diverse support needs, so there is no one size fits all Autism approach to help them regulate. When choosing regulation strategies for use at home, start by paying close attention to your child (even write it down) to observe which senses the child seems to be seeking more input from and also when/at what times of day they seem to require more input. This helps narrow down which type of strategies e.g. visual or tactile etc to start with and whether the child may need something alerting or calming at that time. It’s important to note that some autistic children may have developed their own sensory regulation strategy already. If this is working well and you may not need to change or add anything else at all! If this is the case, try to note how they self-regulated and see if it can be replicated in other environments. Lastly, if the child’s sensory system is clashing with something in the environment e.g. a smell or a noise, consider changing the environment before adding more sensory regulation strategies for the child.
- Heavy work is a useful strategy that can helps you self-regulate whether you are under or over alert. This describes any activity which involves stretching or exercising the muscles or joints usually against resistance. One of the simplest heavy work strategies could be by going for a walk with a weighted backpack e.g., filling a backpack with filled water bottles. Trampolining is another heavy work activity which can help you to feel calm and relaxed (making sure that the child isn’t doing flips which tend to be alerting). If you are in school or work and cannot take a long movement break, a simple chair push up, wall push ups or even pushing your hands against the desk can be a great simple alternative. Yoga also is a heavy work activity that has been shown to reduce anxiety in autistic individuals.
- Swings are a very useful piece of equipment to regulate. As discussed, the movement system (vestibular) is key in regulating information coming in from the other sensory systems too. You can purchase both and outdoor swings from many mainstream and special needs toy suppliers.
- Weighted blankets are great simple pieces of equipment that can help children to self-regulate at home. They can be particularly useful to wind down after school or before bed. It is important that these be no more than 10% of the child’s weight and should not be in any way restraining.
- Fidgets are simple sensory tools that can help you concentrate or pay attention during work or school.
- If a child is very sensitive to touch, deep pressure can help reduce sensitivity. Parents can incorporate deep pressure at home in a variety of ways. Skin on skin methods such as a massage can be uncomfortable or ticklish for autistic individuals. The ‘hot dog’ method is a useful alternative. This involves wrapping your child up tightly in a blanket, (leaving their head exposed so that they can breathe and never leaving the child unattended). Once they are wrapped in the ‘hot dog’ squeeze down along their body or use a massage or pilates ball and gently squash along their body. As discussed, this helps to block every day sensations (like the feel of clothes) that many autistic individuals find uncomfortable. Alternatively, massage balls or toys can be used to self-massage in order to achieve the same outcome. These methods work best if done regularly (as part of a sensory diet) in order to keep the child calm rather than using them once the child has become distressed.
- Yoga and meditation are other methods which can be very useful to help children feel calm and learn to regulate their own emotions or behaviours. Yoga targets key areas of Autism-related sensory processing such as proprioception and body awareness as well as breathing which can benefit and improve how an autistic person will regulate their sensory environment.
There are a number of changes you can make to provide an autism-friendly environment where it is easy to regulate.
- Choose calming colours throughout the home such as muted greens, blues, pinks, soft oranges and neutrals and avoid over-use of patterns throughout the home.
- Choose matt paint rather than sheen as this tends to reflect the light more.
- Ensure the house is as clutter-free as possible in order to keep a calm environment in the home.
- If your autistic child is sharing a bedroom with one of your children, try and separate off their space so that they feel like they have their own private calm space that they can retreat for self-regulation. Dream tents are great ways to do this in a smaller space.
- Choose warm lighting rather than white or bright lights. Opt for using roller blinds rather than venetian wooden blinds which can reflect patterns of light through the house when the sun is shining.
- Consider where rooms are in relation to the kitchen if the child is sensitive to food smells. For example, maybe your child could do their homework at a desk in their bedroom rather than at the kitchen table in order to help them focus on the task at hand and not be distracted by their sense of smell.
- Some children may not like going into the bathroom to brush their teeth or use the toilet because of loud fans in the room. Can your child brush their teeth elsewhere or can the fan be replaced with a quieter alternative or is there another bathroom without a fan which they can use?
- Set up a sensory space in the home which your child can retreat to if they are feeling overwhelmed. Involve your child in setting up the sensory space in order to customise and tailor it to their needs. Allow them to choose sensory toys, fidgets or other equipment that might help them to feel relaxed and calm.
While out in public sensory kits you may need a sensory kit that involves a wide variety of items such as ear plugs, sunglasses, scented tags, mints etc due to the typically more busy and changing environments involved in public spaces. At home choose a select few items that are important to your child. Your child’s sensory needs are unique to them and therefore their sensory kit should be customised to those needs. Again, there is no one size fits all Autism approach to self-regulate. You might include items such as stress balls, fidgets, soft or weighted blankets etc. It may be a process of trial and error to find what works best for your child. When you do find items that suit your child it can be useful to buy multiples so that you have replacements on hand if they are to go missing or break etc.
Sensory rooms are created to help individuals meet their sensory needs. These are calm, relaxing Autism-Friendly spaces that individuals can go to in order to self-regulate. A child can visit a sensory space or a sensory room when they need a sensory ‘break’. A child may need a sensory break from their school day in order to continue to focus and engage with the curriculum. It is a space where a child can ‘recharge’ in order to continue about their day. A few items that can be useful for including in a sensory room can be a weighted blanket, a beanbag, controllable lighting, a rocking chair or swing, some books, some fidgets and ear defenders.
Although there is no universal Autism-Friendly approach for regulation, there are methods to identify how your child will self-regulate. The Zones of Regulation is an evidence-based framework that can be used to teach children about emotional and sensory self-regulation. This framework can teach children to recognise their different emotions or zones based on a colour coded framework and how they can use strategies to return to their “green” or safe zone.
While self-regulatory behaviours are necessary and helpful for individuals to manage their environment, this does not always mean that people adopt safe behaviours when self-regulating. It can be difficult if your child chooses to adopt harmful self-regulatory behaviours such as nail biting or more harmful behaviours like hair pulling or even banging their head. In these cases, it is important that you work at finding your child a replacement behaviour for this self-regulation. Notice what it is that the self-regulation is providing them from a sensory perspective. For example, with hair pulling it is the sensation to the scalp or fingers they find regulating. Then try and find a suitable replacement activity that matches the sensory need, so with hair pulling you may try a fidget or perhaps a head massage instead. This may involve a certain amount of trial and error to replace the pre-existing behaviours. With younger children particularly, you may also need to positively reenforce use of the new tool/strategy e.g. a sticker or reward chart until they get used to it. With patience and cooperation between yourself and your child can work towards finding a positive way for them to self-regulate without causing themselves or anyone else harm