Is Tackling Rigidity in Children with Autism Spectrum Disorder (ASD) Important?
My interest in rigidity began while working as an Applied Behavior Analysis (ABA) therapist with a child with Autism Spectrum Disorder (ASD). This child displayed rigidity in eating behavior, as in eating tiny pieces and refusing to eat certain textured foods. While working on his eating behavior in therapy, I noticed that this child insisted on being first: First to go on the bus, first to leave school, first to answer a question, etc. Failure to do things his way would result in a tantrum such as screaming and throwing things on the floor.
Having worked with several children with ASD over the years, I witnessed several rigid behaviors varying in intensity and severity. Some parents report not being able to take vacations because of all the changes that come with traveling. Others report their child displaying several problematic behaviors (screaming, biting off their hand, etc.), because the road to school was blocked on a particular day, forcing them to take an alternative route.
To all the exhausted mothers out there, here are my suggestions. Keep in mind that the following strategies are what has generally worked for me as a therapist. Every child is different, some require the professional help of an ABA therapist.
- Switch things up.If a child insists on sitting on a particular chair, ask them to sit in another one. If you notice whining and refusal to sit, try intervening gradually. Ask them to sit on a less preferred chair for a short interval of time before allowing them to sit on a preferred chair for a longer period of time. You can gradually reduce the time spent on the favorite chair while increasing the time spent on other chairs. The same goes for the order of presentation of the material you are working on. Some days you want to start with preposition training followed by emotional regulation training. You could switch this presentation order the following day. Alternatively, you can also interrupt whatever they are doing and ask them to engage in a different instruction. The point is to switch things up and favor doing things in a variety of ways.
- Develop functional communication skills. Teach children to say “My way,” when they want to do things a certain way. This is where I usually see children with ASD line toys up or engage with the material in a distinctive, particular manner. To help children understand that they need to be flexible and not always do things their way, you can use a green card placed in front of them to signal when they can do things their way. Inversely, a red card indicates that they need to follow the adult’s way. I recommend starting with a less preferred activity before gradually moving to activities or toys that are highly preferred. By beginning with less reinforcing activities, the child is less likely to be rigid about change.
- Use visual schedules. You want to give children some control in some instances while removing control in others. For example, prepare pictures of your children’s morning routine and place them in order so they can independently follow and complete this routine. Such a routine can look like: Using the toilet, washing hands and face, brushing teeth, getting dressed, and eating breakfast in the kitchen. This will help children complete the routine without the parent having to use verbal prompts. Using visual schedules will hopefully help increase the individual’s sense of autonomy.
- Token boards can help the child tolerate delays or accept things being done differently. I usually ask the parent: “What does your child like?” Use the images of that particular interest on the token board. For example, while working with a child who loved Star Wars, I decided to use Star War characters on the token board. After having collected a specific number of these tokens, the child will access a preferred activity or toy of their choice. Be creative and follow the child’s interest.
- A bag of surprise reinforcerscan be helpful. Be mindful of the texture of the bag given that some children with ASD have sensory preferences. For example, one child I worked with liked velvety textures. Based on this child’s preference, I used velvet bags where I placed several preferred items. I would ask the child to put his hand in the bag to choose a reinforcer. The child was not allowed to peek, nor was he allowed to select a different toy. What he picks, he gets, until the next trial.
“To everything there is a season, and a time to every purpose under the heaven.” Ecclesiastes 3:1
Rigidity is a cornerstone of ASD and can get in the way of social, educational, and community inclusion. Rigidity could also be associated with problematic behaviors. Given the importance of rigidity and its possible negative repercussions, the earlier it is addressed, the sooner the improvement in socially acceptable behavior. Keep in mind that a child displaying problematic behaviors is generally easier to physically handle than an adult. Start early!
I want to sincerely thank Jennifer Chebli, BCBA, for her critical insight and unwavering support. Working with you makes a difficult job seem easy.