I’m adding this addendum to my last post because this happened, and then this excellent, perfectly stated response happened. And I realized that in my last post when I said if your child doesn’t like going somewhere don’t go, it may have sounded like I was suggesting “just be house-bound” or “don’t try outings that may be difficult.” It may have come off as cavalier and that was not my intention.
My intention was to say: (1) go places your child likes, as opposed to places you think he/she should like, and (2) if its a place you think they would enjoy if only it could be accessible for them, work on making it accessible rather than forcing them into it in spite of it being set up in an inaccessible way for your particular child (eg sensory overload). And finally, remember, as Tonia points out, sometimes you have to be patient and wait until your child is ready to enjoy certain outings/activities, because our kids have their own timeline, and it diverges from the neurotypical timeline for a lot of things. And that’s okay.
Let me give some examples from my own experience.
Up until a few weeks ago, we had not gone out to eat as a family in about four years. R. simply could not tolerate that environment, and the few times we tried it involved one parent going outside with him while the other ate with my older two kids, then a switch so parent #2 could eat while #1 went outside with R. We found this arrangement rushed and unenjoyable, so we stopped trying to do it. This was not an autism tragedy. We simply adapted. We enjoyed plenty of take-out instead, and from time to time my husband or I would take the older kids out to eat while the other parent stayed home with R. This gave us a chance to have one-on-one (or one-on-two) time with them. My husband and I would also occasionally go out for lunch just the two of us while the kids were all at school. It worked, and it was no big deal. But a few weeks ago, at age 5, we were able to go out to eat, all of us together as a family, for the first time in years. It was exciting and we had fun. And yes, it only worked because we set up strategic accommodations for R, and because we were patient enough to wait until he was ready and able to handle it. In terms of accommodations, we went during non-peak hours because R cannot tolerate large groups of people. We grabbed a large L-shaped booth in the back where we stationed ourselves on either end of the L-shape so that R could not bolt away, but had plenty of room to pace and jump back and forth along the L-shape. We chose a restaurant with very loud music so that R could vocally stim loudly without disturbing others. We brought his iPad so he could watch his videos, and we brought his own food (the restaurant was gracious enough to allow it) because his diet is very limited and we knew he would not eat anything we ordered. I also want to reiterate that even with all these strategies in place, for the last few years it still wouldn’t have worked because he wasn’t ready yet. And I think I should point out that R is hyposensitive to most sensory input, which is why this worked for us. A child who is hypersensitive would need a quieter restaurant, and perhaps headphones to cancel out the background noise.
In the beginning of this post I linked the Washington Post article about a mom who traumatically forced her five-year-old Autistic child into indoor spaces that caused panic attacks for him in an effort to make him overcome his anxiety. Anyone who has followed my blog knows that for a very long time R had that same anxiety and panic in unfamiliar indoor spaces. I have written about it in several posts like this one and this one. Our approach for places he *had* to go to (not like Ellenby, who forced her son into a Sesame Street concert) was to work on it for months in the tiniest possible increments. And when it came to non-essential places, like recreational spaces, we waited, and in the meantime, spent lots of time outdoors since he was fine in outdoor spaces. This was limiting at times. We could not visit family, they had to visit us. If we wanted to take our older two somewhere, one parent (usually me) had to stay back with R. But it wasn’t the end of the world and it wasn’t all about our sacrifices as parents. We tended to think of it terms of poor R, who had to struggle with this huge anxiety despite being such a tiny little boy. I have anxiety myself and have experienced panic attacks. They are so terrifying. And knowing that my toddler was having panic attacks broke my heart into a million pieces. So no, staying away from places that caused a panic attack was not some huge sacrifice for us, it was really the least we could fucking do for our sweet little boy. So we waited, and as he grew and acclimated to more indoor spaces (school, doctor’s office, etc) we slowly introduced new spaces with careful accommodations in place. For example the Boston Children’s Museum does accessible mornings and evenings where they will open the museum during off-hours. It is open only to children with disabilities and their families, they limit it to a small count of people (R cannot handle crowds so this is crucial for him), and they make sensory accommodations like low lighting and sound. The first time we tried it he could only handle it for about 15 minutes, then he needed to leave so we left. The next time he was able to stay for a whole hour. We followed his lead and took it slow. Now, at 5, he is in a place where he can go most places as long as it is not crowded and for discrete amounts of time (he makes it very clear when he is done and needs to go). He also generally needs to be able to stim freely to help himself cope, so that also factors in when we choose where we are going.
The bottom line is be flexible and be patient. And if, as time goes by, you see that the severe anxiety is not abating despite all efforts and despite the child’s growth and development, eventually the option of medication should be considered. I know several parents of Autistic children for whom pharmacological treatment of severe anxiety was life-changing. I’m sure you can imagine what it’s like to finally see your happy, smiling child again. We need to end the stigma surrounding medications for mental health. It shouldn’t be the very first thing we jump to, but when other approaches fail, an individual should not be left suffering when there are pharmacological options that could greatly improve their quality of life.
Alrighty, I’m off my soap box. Thanks for listening. 🙂