Teaching New Coping Skills Most problem, acting out, behavior from children on the spectrum is an attempt to escape or avoid situations that they do not immediately know how to handle. Because the world is filled with much uncertainty and chaos for the children, they are very “alert” and “on guard” to any situations for which they do not automatically now what to expect, and how to handle it. Consequently, when put in situations of uncertainty they go into “panic” mode and “fight or fight” kicks off. Now, at first we help them by making the world more understandable and predictable. We can help lower anxiety and uncertainty by providing strong structure and predictability to their day, and by preparing them before heading into events by previewing what they can expect and what is expected of them. This helps avoid some of the “uncertainty” that freaks our kids out. However, the world is very dynamic and represents continuous change and uncertainty, and the children eventually need to learn how to cope with uncertainty and to deal with anxiety. This is one of the most important tools that we can teach the children; to feel competent in the face of uncertainty, feel confident tackling anxiety, and learn coping skills for regulating their emotions. In order to tackle uncertainty, you need two primary strategies: (1) teaching coping skills to deal anxiety, and (2) providing gradual exposure to uncertainty, to learn how to successfully use the coping skills. There are several steps with each strategy that needs to be considered Learning coping skills 1) First you have to choose one or two coping skills that might fit well for the child. That will depend on the age, interests, cognitive abilities, and sensory preferences of the child. These can include deep pressure calming techniques, deep breathing, muscle relaxation, positive distracting thoughts, counting, singing to self, fidget items, focusing on special interests, power cards, etc. 2) Next, the child needs to learn how to use these techniques when not under stress. They need to practice with you when calm; role playing situations, and learning to feel competent before testing them under fire. We make the mistake of discussing the coping skills with the child, and then expecting the child to use them in the heat of the moment. Even though the child may intellectually understood what to do, they are not able to perform under fire, leaving both the child feeling more incompetent, and the parents feeling confused (“He knew what to do, we discussed it a head of time. Why didn’t he do it!”). Knowing what to do, and being able to do it, are two different things. They have to rehearse the technique in role playing situation to become skillful in implementing it. The role playing has to be life like, with coaching from the parent. We usually do this by having the parents and child list out recent situations that cause stress, and write them on index cards. Each day they pick out a couple of cards and role play the situations, practicing the coping skills. The parents and children do it together, often switching roles, and having fun practicing the coping skills. 3) Finally, we often create little snags during the day to practice the coping skills. This creates real life situations, during the daily routine, that produce mild stress in order to practice the coping skills on the spot. There are two aspects to this: 1) Parents will often create little snags for themselves, when their child is with them, so they can highlight themselves using the coping skills. For example, while doing something with your child make a simple mistake. While talking out loud display initial frustration, “Oh no! I just tore the paper! Ok..I need to take a deep breath, count to five, and say ‘I can handle this’.” This way the child can see you successfully using the technique under stress. Then (2) create little, mild snags into the child’s day where you can immediately pause and coach the child in using the coping techniques. Gradual Exposure to Uncertainty 1) Once the child learns how to successfully use the coping skills then it is time to “up the ante”. Make a list of common stressful situations for the child, creating a hierarchy of least to most anxiety provoking situations. The beginning of the list consists of very minor snags that will cause some stress for the child, but now overwhelming stress. Schedule, and plan out, frequent situations on the “easy” list, so the child has frequent exposure to minor stressors. 2) If possible, prepare the child a head of time, “Ok…we are going to the store. Now, remember the noise and activity sometimes bothers you. Remember the coping skills we use for this?” If needed, briefly practice it before going into the situation. 3) When in the event watch your child closely. As they start to look a little stressed, pause and coach them, “Ok…we are getting a little stressed, less practice our deep breathing and counting.” Focus on how successful you both are at handling the situation. 4) As the child becomes skillful in using the techniques in mild events, they are building feelings of competence and confidence in using the skills. As they learn to cope with the mild events start to gradually work your way up the hierarchy, keeping the anxiety low enough that they can feel it, but it is not overwhelming. Focus on (a) doing it together, and (2) feeling the mastery of tackling the anxiety. This helps build strong feelings of “I can do it!” By using these two strategies the child starts to feel more confident and comfortable in tackling stressful situations. What you will notice is, as the child learns better ways of coping, he becomes less anxious in these situations. His “fight or flight” response gets reset to a higher level, so he doesn’t go into panic mode at the first signs of anxiety. He begins to feel more “competent” facing uncertainty and anxiety. This will help the child learn to cope with the daily stressors that will be inevitable in his life.
Posted on: Mon, 01 Jul 2013 02:27:14 +0000
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