Aug 1, 2019 in Therapy

Autism: Coping with Change - The Anchor Point Strategy

How does change effect autistic individuals, why are predictable routines so important & what can we do to help?

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“We have to travel the same route each day or he’s too upset to go into school”

“It has to be fish fingers and chips for dinner every day or he doesn’t eat a thing”

“We can’t afford to change even the smallest detail or it can upset her whole day” 

Many of the questions parents and carers of autistic individuals ask me are related to the challenges around the need for set routines and difficulties coping with change.  They explain that this can make life even more challenging for the whole family because no matter how hard they try, it’s just impossible to keep everything the same, change is an inevitable part of life. 

Putting Yourself In Their Shoes

A concept I often use with my clients to help them better relate to the individual they are supporting is to find a situation that would cause a similar reaction in themselves. In this case, a good analogy is the notorious yellow diversion sign. I don’t know about where you live but here in West Essex, there seems to be one round every other corner.  

I’m sure that most of you have been there either as a driver or a passenger. Just imagine the situation… 

It’s a lovely sunny day, you’ve had a wonderful time with friends and are now heading home. The journey is going well when all of a sudden in the distance you spot it, the dreaded yellow diversion sign. You follow the first one and as you approach the next roundabout you cross your fingers and hope there’ll be another. Thank goodness there is, but now you’ve travelled 5 minutes down the road. A further 10 minutes but you’ve not seen another sign. Things are starting to look more and more unfamiliar, your anxiety level begins to rise. You look to your phone only to see a single bar of reception and not one sign of any 4G. Now your anxiety levels are sky rocketing. You’ve got no choice but to continue driving in the hope that you’ll see another yellow sign but this doesn’t see likely. 5 more minutes pass when you see a pub in the distance, as you get closer you realise it seems familiar, yes your pretty sure you came here a few weeks back, if you are right there will be an old telephone box on the green.  Yes, there it is! Suddenly your anxiety lessens a little. Now did we turn left or right at the end of the green, I’m sure it’s left.  You follow your instincts and as your travel down the road you see a sign for your town. Your anxiety drops another notch or two. You follow the sign and within 5 minutes you are back on a well-known road, you know exactly how to get home now.  Your anxiety is almost gone.  The next thing you know your pulling into the drive way. You open the front door, shoes off, bag and coat on the peg where they always belong.  You walk into the kitchen, flick the switch on the kettle. Teas ready. Warm cuppa in your hand as you settle down on your comfy sofa, not a sign of anxiety left in your body now your home safe and sound.  

Did you notice the more unfamiliar and unpredictable things became the higher your anxiety levels rose and as things became more familiar and predictable the anxiety level dropped again. From my work and conversations with autistic individuals this is not dissimilar to their experience when they encounter change and their routines and patterns are disrupted. However, whilst this type of experience is rare for the majority of us for autistic individuals this can happen on a daily basis, if not several times a day.  So, how can we help reduce these situations?    

Why change can be a challenge. 

Before we can put strategies in place we first need to understand the role set routines and patterns play in the life of an autistic individual. One characteristic of autism is often described as a difficulty with social imagination. This means they can find it more challenging to read contextual clues within the environment or to see the perspective of another person.  In turn this can affect their ability to recognise, understand or predict what will happen next and how others are likely to behave. In addition, many individuals may also experience high levels of anxiety as well as sensory sensitivities.  Hence their preference for set routines and their resistance to change. The more predictable their environments, the calmer and safer they will feel.

The same thing, the same way, at the same time.

One strategy I use with my clients are ‘anchor points’. These are the parts of their day that incorporate their routines and patterns, they feature things that are very familiar and very predictable. Just like the pub, the telephone box, the cup of tea from our analogy. They are elements in their day that they understand well and therefore give them a sense of security. They are things that always happen at the same time in the same way.  

For example, when I taught in a special education school we ALWAYS started the day in the same way. Pupils would hang up their bags and coats and place their home communication books into a basket that was ALWAYS in the same place. They would then complete their individual work tasks at tables that were ALWAYS in the same place and once everyone had arrived we would gather for morning circle, a highly structured group session that ALWAYS started with the hello song, followed by the day of the week and finally the weather. The session after this could be different each day of the week but would ALWAYS end with snack time followed by playtime. The rest of the day would work this way with less familiar and predictable activities sandwiched between regular and highly predictable routines, that ALWAYS happened at the same time in the same way. In this way we were able to introduce the pupils to new ideas and concepts and to help them broaden their life experience whilst developing crucial academic and life skills.   

It may take time for anchor points to become established, especially when you are creating new ones but the more times those anchor points are experienced the stronger they will become, so keep persevering. Anchor points won’t eliminate anxiety around less familiar activities, at their best they will give individuals the capacity to go outside of their comfort zone as they will have a clearer idea of when they will be back in it and at the very least they will help ensure that anxiety doesn’t build up too much during the day by provide individuals with regular opportunities to regulate their senses and emotions.   

Are anchor points going to be featuring in your day? Perhaps they already do, if so what do they look like?  Are they working or do you need to tighten them up, remember the more predictable an anchor point is the more security it will bring and the quicker the individual will feel safe and calm again. 

If you’re supporting an individual who struggles with change I’d be honoured to come alongside you to create effective anchor points and additional strategies to help make their world feel like a safer place. Just get in touch to learn more.

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