Creating Autism Interventions that Promote Flexibility: Your Ultimate Guide


Autism and flexibility

One thing we know about the learning style of people on the autism spectrum is that there is often a strong adherence to routines. This can sometimes really work to their advantage. Imagine the child who always comes into the classroom, hangs their backpack, washes their hands, and then gets out their supplies.

But it can also be an incredible source of stress. Many times a can come to depend on a routine, and when that routine changes it is like the rug has been pulled out from under them. And let’s face it, in our daily lives, even the most functional routine is subject to change. There are fieldtrips and fire drills; parents have appointments and holidays; weather interferes with our outdoor plans. There are a thousand reasons that every routine will eventually be challenged.

Maybe this has happened to you: you create a schedule to help a child on the spectrum with transitions during their day. You add pictures, laminate it, and teach them to use it. And it really helps! But when the schedule changes, suddenly they become so much more stressed.

Or perhaps you’ve created a routine for your therapy sessions to make the sessions more predictable. The child always starts with the same activity, does four tasks at the table, plays with the same selection of toys, gets a snack, and leaves. But then you add a new goal, change the routine, or make some other necessary change, and everything falls apart.

Or maybe you’ve taught a child to use a new toy - and they loved it! You celebrated their success, and then realized that they will only use it in the exact way you taught it. Letting others use the toy or using it in different ways is stressful and unexpected for the child.

As therapists, we must ask ourselves: are our interventions creating new rigid routines that will bring more stress for the child when they change? If your answer is yes, don’t worry. There are things you can do to help your clients learn to use their new skills with greater flexibility so that they can thrive in a world that demands we adapt to constant change.


But First, A Caveat

Before we dive deep into flexibility, I want to pause and acknowledge that keeping routines is okay. We can respect the learning style of our autistic clients and not try to infuse flexibility for flexibility's sake into every routine and activity. BUT if the activity may one day change, teaching that possibility from the beginning can reduce stress in our clients' lives.

Why Flexibility Matters

It’s easy to ignore the question of flexibility and keep moving forward with the status quo, especially if your clients are making progress in your sessions. Many of us will be tempted to write goals that don’t consider flexibility, and when our clients meet their goals we simply consider them done. We teach our kids to use new materials, to eat new foods, to follow a schedule, to do academic or fine motor activities at the table. And when they can do them, we mark the goal as complete. On the surface, we are doing a great job.

But as our clients move into the world, the schedules change, the toys look different or must be shared, the food comes in different packaging, and the learning activities are presented in a different way. For those of us who don’t struggle with flexibility, this is no big deal. But for our kids who count on their routines to stay the same, this can be a major stressor.

Take a step back and consider the things you really count on to be the same. You know where to find your toothpaste in the morning. Your shoes fit on your feet every day. Gravity always keeps your furniture on the ground. Imagine your frustration if your toothpaste was suddenly in a different place each day, and you couldn’t predict where to find it. How would you feel if your shoes suddenly didn’t fit for no discernible reason. Or what if you came home and your furniture was on the ceiling. You would probably begin to feel anxious…after all, if you can’t count on these things to stay the same, what can you count on? Is the world so unpredictable?

turned upside down

For many autistic kids, changes in routine can feel like the furniture suddenly being on the ceiling. And when we’ve taught them to expect things to stay the same and then things suddenly change, we’ve helped create this stressful and seemingly unpredictable world for them.

While we can protect some routines that our clients rely on, the overall answer is not to make sure everything stays the same. In the long run that won’t help, and even in the short run it will reach its limit of feasibility very quickly. We also don't want to take away routines and predictability without giving our kids the tools they need to cope with and understand the change.

The answer is to teach our autistic clients to use new skills flexibly from the beginning.

When we teach with an eye for flexibility, we can watch as our kids learn to look to their schedules to see what changes they can expect that day. We’ll feel proud as they use their materials in a variety of ways, share them with others, and use their new skills in different places and under new circumstances. We’ll create systems that allow our kids to know what to expect even though things may change day to day or session to session. And we can feel proud that we are truly helping our clients cope with their ever-changing daily lives.

How to Teach Flexibility

If you’re ready to teach flexibility, it’s essential that you teach your clients to look at their systems (schedules, to do lists, etc.) to see what to expect, rather than to rely on a memorized routine. Here’s what I mean: when I look at my calendar each day, I know it will tell me what I need to do on that day, but I also know I cannot count on it to be the same each day.

If my schedule is always the same, I’ll probably stop looking at it. Then I may be surprised that I’ve missed an important one-time appointment (sorry dentist!). Similarly, I may come to expect it to be the same and feel duped when it changes. If my job was always to see six clients in a day and then one day without warning I was asked to see 12, no chance I’d do it without complaining.

Here are a few things you can try to help teach your clients flexibility:

1. When you create schedules or to-do lists for your clients, create systems that require them to do something. This may mean checking things off of a list, moving pictures or objects to finished, turning pages in a flip book, or even using objects functionally. If you create lists or instructions that are just for reference, they will certainly be ignored.

2. Make changes early and often on your schedules. If you make a schedule that will stay the same and laminate it, not only will your clients not use it, they will also expect it to remain the same.

Instead, make a schedule that allows for change. It doesn’t need to look beautiful. It just needs to show your clients what to expect. Here are the two types of changes you need to be able to show: