Autism and Transition

     Transition is incredibly uprooting. It shakes the foundation of a child as an earthquake shakes a building. Transition is coupled with intense anxiety and fear for children. The basis of their everyday life is changing and it extremely affects children. In general, all children are affected by transition. Most children with autism do not have the capacity to easily deal with transition in their lives. Transition is one of the most difficult challenges for a child with autism.
     Transitions are hard emotionally, physically, and mentally. Emotionally the lack of consistency can be overwhelming and unnerving. The stress of transition can take a toll on the body physically. Transition can mentally make one feel ungrounded and uprooted until a regular schedule evolves.
     During times of transition children often feel emotionally overwhelmed. The absence of a consistent daily schedule makes them feel unrooted. Children get anxious and stressed out about what is to come. It is as if they have nothing grounded to hold onto in the tornado of a transition. A regular schedule helps to ease anxiety because they are able to predict what is ahead. Stress from transitions can affect their capacities. Mentally they can only handle the task at hand while adjusting to transitions. It is difficult to multitask at these times. The mental energy is occupied with the current transition. Concentration is compromised during transitions. There is no mental energy to spare.
     Once the routine is shifted in an autistic child’s world a number of symptoms can arise. The child could have trouble self-regulating, controlling impulses, and keeping their body safe. It is often a struggle to regulate tension in their body. They cannot embody excitement in these overwhelming times. Attention is also compromised when they cannot self-regulate during transition. When they are stressed out or feeling overwhelmed they become driven by their impulses. They will often tend to lash out at intrusive external stimuli. These aggressive reactions are attempts to control the over-stimulating world around them.
     When autistic children are in an escalated state they have trouble staying in their body. These escalations can be due to excitement, anxiety, or sensory overload. When they are not conscious of their body it could be a danger to themselves or others. Their balance and spatial perception become impaired. Vision turns into tunnel vision. They will often bump into or fall on others. They lose track of where their body is in relation to others and exterior objects. Others’ theories explain the phenomena of these children’s inner workings.
There is a theory about children who suffer from sensory integration problems. Often autism comes with features of sensory integration problems. These children are so chaotic and inconsistent inside that they look for external consistency to ease them. Their chaos is due to their inability to process external and internal sensory stimuli. They receive the stimuli, but their body does not know what to do with it. The stimuli that others can process easily overwhelm these children. Stimuli on the skin can often feel like intense somatic sensations to them. A loud noise registers as extremely loud or high-pitched sounds. Excitement or emotional escalation can translate to extreme ungrounded escalation. This internal chaos feels out of control, hence the child feels that they are out of control. In turn, feeling out of control inside can be eased by controlling their outside environment. This is often the reason that special needs children have issues with control.
     Control is a major factor in determining behavior in special needs children. “While you may find the behavior annoying, disruptive, or inappropriate, it may be filling a need for your child. And even if your child is genuinely unhappy about the negative consequences of his or her behavior, he or she may not understand it enough to control it,” explains Terri Mauro a writer who specializes in special needs, behavioral issues, and adoption (About Inc: Primedia, 2005), p1. The lack of control and ability to control contributes to complications in the interaction and behavior of special needs children.
     Adelle Jameson Tilton a medical professional who specializes in special needs children and behavioral issues writes about autism and routine. “Autistic children need uniformity, structure, and routine. As time went on, the child realized that his/her routine was not right, and began to act out” (About Inc: Primedia, 2005), p2.
     My theoretical perspective on autistic children’s trouble with transitions is a reciprocal relationship of control. The child is experiencing a change in their daily routine. This daily routine is the basis of their life. This is what they wake up to and what takes them through their day. This routine is the consistency that holds them safe. It is what they have come to expect out of their day. Routine alleviates stress because it makes their life predictable.
     Transition in routine cracks the foundation of these children. It is only natural that at this time acting out occurs. This adjustment to daily life feels out of their control. In a sense, it truly is out of their control. The child did not choose this transition, life did. When they cannot control their environment, they feel out of control. The child feels overwhelmed and as if their control has been stripped away. Now the child needs to get that control back.
     The way that these children often get this control back is through recreating consistency. In the past when the child has been naughty they would get reprimanded. This was a consistent and expected cause-and-effect dynamic. So they try it out. When they act out they get in trouble, just like in the past. It feels consistent and predictable. Now when other areas of their life feel unpredictable they act out and get in trouble, which is their expected outcome. This getting in trouble releases some anxiety because they have found some consistency. At least this is the same. Then the child continually acts out and gets their predictable reactions from the parent and it eases their stress during transitions. In a sense, the child gains their control back. They may not be able to control their unpredictable school schedule, but they can still control when they get in trouble. These children find comfort in the consistent reaction from mom when they are in trouble, even if it is a consistent negative reaction. Acting out gets these children’s needs met.
     Children’s issues with transition are rooted in control. Children function at an optimal level when they have a sense of control over their environment. The predictability of a daily routine eases the children’s control issues enough that they do not have to continually grasp for exterior control outside of themselves.

Jennifer Watkins, PsyD, QMHP, Psychologist Resident

References:
-Mauro, T. “Behavior Analysis Basics, The 5 W's.” Internet: About, Inc PRIMEDIA, 2005, http://specialchildren.about.com/od/behaviorissues/a/analysis.htm retrieved from website on 1/2/05.
-Tilton, A. J. “Changes in Routine Equals Changes in Behavior, Behavioral Deterioration.” Internet: About, Inc PRIMEDIA, 2005, http://autism.about.com/library/weekly/aa010701a.htm retrieved from website on 1/2/05.