What steps can a parent take to have a bedtime routine for an autistic teen? -Denise, Columbia, MO

Denise,
First off, we cannot claim to be experts on autism. We hope that you have some local support to assist you with managing your child's behavior. If not, please drop us a line and we can try to help connect you with local resources. Autism is a broad label and children experience many different degrees of autism. We can try to give you some general ideas that may help depending on your child's level of coping skills. But, we strongly suggest that you contact a local professional to get more support and suggestions.

As you know by now, children with autism often thrive on routine. So, establishing a bedtime routine is a great idea. What you incorporate into your routine will depend on your child. Now that your child is a teenager, you might want to check out our article called "Is Your Adolescent Sleeping Enough" as some of your teen's sleep patterns are changing.

Most importantly, stick to your routine. Routines are important to kids in general and even more important to kids with autism. Routines provide a sense of security and predictability. Write your routine out and provide visuals if necessary. Post your bedtime routine in a place your child can see easily. Go over your routine nightly with your child and have your child check off each part of the routine after it is completed.

Here are a few reminders to help your child settle into bedtime a bit easier. First, it can be difficult for kids with autism to settle down after an especially stimulating evening. Give yourself a longer period to unwind and settle in if the evening has been a bit more exciting than usual. Make a set time to go to bed and get up in the morning, and try to stick to it as much as possible. Limit the amount of sensory distractions that may bother your child during the night. Bedroom lighting, sheets and blankets that may sound noisy or feel scratchy, and the sound of clocks ticking are a few examples. Also, avoid sugar/caffeine late in the afternoon or evening.

As mentioned, you will have to design your routine based on your child. Here is an example of what you might do. First, decide on a time that your child will begin to wind down for the evening...9pm for example. Assume that the hour before bed is "unwind time". During this time you can check off certain "unwind activities". These activities may include taking a warm bath, listening to calm music, and reading (your child can read alone or you can read to your child...even teens like to be read to!). Pick activities that your child enjoys and will be engaged in. Also, you might include an evening triptophan snack. Triptophan occurs naturally in certain foods and converts to melatonin in the body (a hormone which tells the body when it's time to go to sleep). Some foods which contain triptophan are yogurt, bananas, eggs, warm milk, nuts and seeds. Have your child check off each "unwind activity" after it is done. After unwinding, have your child prepare for bed by doing things like brushing teeth and getting in pajamas. Then, it's off to bed. We have a bedtime routine chart as an example on our site. Click here to check it out. This will give you an idea of the type of chart you can develop for your child.

Since your child is a teen, you can probably expect the bedtime hours to vary depending on social activities. Again, this will depend on your teen's lifestyle. If your child is out late and arrives home right at bedtime, remember to still give him/her time to transition to bed. As you may know, transitions can be difficult for kids with autism and you still need to provide some time for your child to unwind before bed. In this case, you may want less "unwind activities" but still provide some down time before bed. Again, keep the routine structured, consistent, and clear. Hopefully, your child will be able to continue the routine into adulthood.

Best of luck with your teenager!

Ideas for eliminating spitting in the class-room. Still to work out the reason. Down Syndrome boy aged 5 years 11 months. Have looked at tiredness, wanting to avoid activities, sensory (possible). Gathering data (again). -Jen, New Zealand

Jen
As you know, many children with Down Syndrome have better receptive language skills than expressive. As a result, they may feel incredibly frustrated when they cannot verbalize information, and they may act out their frustration. It may be helpful to have some visual cues to help him respond to you. Possibly, have some pictures representing common responses and situations that he can point to when trying to communicate. For example, have pictures representing "I'm bored", "I understand", "I'm angry", "I need to use the bathroom", etc. It depends on his particular level of communication. We have some feeling charts which may help when trying to figure out how he is feeling each day.

A behavior chart may be a fun way to help him control his spitting. We have added an "I Didn't Spit" chart to our website. You can find in on the following page. We would be happy to break the chart down into smaller time periods if that helps. When he has gone through a day/half a day without spitting, let him mark his chart and give him a reward. He would need an immediate reward for the chart to be effective.

Also, You may want to find out if spitting is an issue at home. If it's only happening at school, then you can narrow down the situations that bring about the spitting behavior. You may be doing this already, but it would also be a good idea to keep some notes/written observations and try to detect some type of pattern to his spitting. You can record things like what time of day he spits, where is he when he spits, who he is with when he spits, etc. It will be a bit of detective work but questions like these will help narrow down the reasons why he may be spitting.

Basically, it sounds like you are going in the right direction with helping him to eliminate this behavior. The best thing you can do is to continue investigating reasons why he is spitting. Using a feeling chart or some other form of visuals can help in the process. Then, you can try to modify his environment so he doesn't experience the triggers which cause the spitting. As mentioned, a behavior charts may also be effective in helping him control his behavior.

Best of luck and let us know if we can help in any other way.

How can I get my 16 year old autistic son to poop in the toilet?-Jennifer, Arkansas

Jennifer,
Thank you for your question and for visiting our website. Though we do have some information on our website for parents of autistic children, we can't claim to be experts in this area. You may need to see a specialist who can help problem solve and support you through the toileting process with your son. You should start with your family physician who can rule out any physical problems that your son may be experiencing. In addition, your physician may have a good recommendation for a specialist who can further work with you on this issue.

You also need to consider any fears your son may have regarding the toilet or any sensations in the bathroom or around the toilet that may disturb him. Is the toilet seat too cold or is there something about the bathroom that alarms him or makes him uncomfortable? For instance, is there a dripping sink that's annoying? As you are most familiar with your son, you are the best person to assess this.

Much of your approach depends on your child's developmental age. You can take a look at our article on Nonretentive Encopresis and Toilet Training Refusal for some ideas. You might try to schedule regular, planned toilet sits where he can earn some type of incentive every time he poops on the toilet. Or, you can even let him earn a reward for just sitting on the toilet and another for actually pooping. Our behavior bucks may be a nice option that allow him to save up for a larger treat. Possibly, he can earn a $1 buck for sitting on the toilet and a $5 buck for actually pooping. We also have some behavior charts for toileting and the older child. We would be happy to make up a chart for you if you don't see anything appropriate.

Some people recommend using an hourglass timer in the bathroom while your child is sitting on the toilet as kids with autism can be impatient and may enjoy watching the sand in the hourglass while they sit. And you can also have interesting reading material available to give him some incentive to use the bathroom and stay on the toilet. Remember that positive reinforcement is a great motivator. So, when your son does make an attempt to sit on the toilet or actually poop, let him know you're proud. You can use one of our "Caught You Coupons" as a tangible reinforcer. Hope some of these ideas are helpful and best of luck with your son!

Hi there. Where I work we have a child that has Autism. He his a really sweet boy. Lately he has been picking up objects and then throwing them nearly hitting someone. He will even laugh when he has done it. We make him pick the object up and say that we don't throw things. Have you got any advise that may help. -Leanne, New Zealand

Leanne,
As communication can be difficult for children with autism, the act of throwing toys may be this child's way of communicating with you. Throwing toys can also be an act of sensory stimulation. In order to find out what is causing this behavior, you need to examine events previous to the toy throwing episodes. What is going on at the time? Was there any disturbing sensory stimulation such as noise, heat, cold, touch? Was the child bored? Was there a transition happening before or after the behavior? Did he want to interact with another child? Did he want your attention? This detective work may take a while. You will need to record several incidents before seeing a pattern emerge.

Next, take a look at the behavior of those around the child at the time of the toy throwing and after the toy throwing. How did the adults and children react? Did the child gain anything from the toy throwing? Did he achieve his goal or get the attention he desired? Once you see some type of pattern, you can begin to address his emotional state before the toy throwing occurs. For example, if you discover that he begins to throw toys when you transition to a different activity, you might better prepare him for the transition. Maybe you can use the same word or a picture every time there is a transition. If you help the child prepare for the transition, you can minimize his anxiety and thus the toy throwing will stop. Or, if you see that he is stimulated from the reactions of the other children, you can teach the children to ignore his toy throwing and set up some type of activity that can provide positive stimulation for him when he is bored. Try to involve the other kids if possible so he can interact with others in a positive way. Best of luck!