Autism and Transitions For Kids

Transitions can be challenging for any kid. But changes in routine or moving from one activity to another can be especially difficult for kids with autism. 

“We all like to know what to expect, and change can be hard,” says Emily Mehta, a licensed clinical social worker in the Developmental and Behavioral Pediatrics division at Lurie Children’s. “Transition is stressful to us as humans.”

Kids with autism may have more difficulty expressing their feelings. They often use behaviors instead of words to express themselves. Here, Mehta offers strategies for how to help children with autism with transitions.

Why are transitions hard for children with autism? 

Kids with autism can be more sensitive to change than neurotypical children. “Repetitive behaviors or an insistence on routine are part of the diagnostic criteria of autism,” Mehta says. 

Yet every child with autism is unique, with their own specific challenges. Some children may have difficulty with new situations, Mehta says. Others have trouble stopping an activity and beginning another. 

“It’s hard to predict how hard a certain type of transition will be for a child with autism,” she says. “The experience of transition varies so much in each individual.”

Types of Transitions

Children with autism may find certain types of transitions harder than other changes. Kids may struggle with:

Activity Changes

Ending one activity to begin another is hard for some kids. For example, they may resist when you tell them it’s time to stop playing online games and get ready for dinner.

Bedtime

Some children may not want to stop what they’re doing to get ready for bed. Others may have trouble settling down for the night. 

Life Changes

Moving to a new house or starting a new school are big transitions for all children. Kids with autism may need extra support in managing these types of changes.

School Routine Changes

Kids with autism may find it especially hard to move from one classroom or teacher to another. Some kids may get upset when they’re expected to sit at a different table or when their friends are absent.

Sensory Changes

Some kids with autism are extra sensitive to how things feel or to the environment around them. Being in a new place with lots of people or wearing a new jacket may feel overwhelming.

Shifts in Routine

Some kids with autism get upset when they have to do something that isn’t part of their typical routine. Taking a new route to school or running out of their favorite breakfast cereal may be difficult for some kids.

“How changes play out at home and at school really varies in kids with autism,” Mehta says. “Some kids are sensitive to noise, room temperature or the number of people in a room. That’s an extra layer for parents to be aware of when their child is facing a change or transition.”    

How can I tell if my child is struggling with transitions? 

Children with autism don’t always have access to the words they need to communicate their feelings. Instead, they communicate through behavior, Mehta says. 

“Some kids are very articulate and expressive about saying what they don’t like,” she says. “But when kids don’t have verbal language, it’s important for families to observe the child’s behavior.” 

For example, you might notice your child exhibits certain behaviors after starting the school year with a new teacher. Or your child may happily go places on the weekend but get upset when it’s time for school. “Some detective work can help you understand the reasons for the behavior and what your child is trying to communicate,” Mehta says. 

Elopement

Running away, also known as elopement, can be especially tricky for families, Mehta says. Kids may try to escape something they don’t want to do or flee from an environment that feels overwhelming. Families may need support to help keep their child safe when elopement is a challenge. 

Your child’s care team can help you create a personalized safety plan for your child. This plan may include:

• Identifying and managing specific triggers that may cause your child to run away
• Installing locks and fencing at your home 
• Telling neighbors and others in your community how they can help keep your child safe   

Refusal 

Some kids just say no when asked to stop what they’re doing and move to the next activity. A child may refuse to go to bed or get in the car to go to school. “Refusing to participate is a very common behavior,” Mehta says.

Shutting Down or Withdrawing

Tuning out or refusing to engage with others is common in people with autism, Mehta says. Kids may avoid transitions by being nonresponsive to others. 

Tantrums

A child’s difficulty with transitions may sometimes escalate to tantrums, Mehta says. Kids may cry, yell or throw things when situations feel challenging.

Transition Toolbox for Families

There are ways to help ease challenges when kids with autism have trouble with change. “We have a toolbox of strategies parents can try,” Mehta says. “It’s important to know your child and what may work for them. But there are also some things that are universally helpful.”

Preparation is an important way to help manage problem behaviors around transitions. Even if problem behaviors still occur, they may happen less often with preparation strategies, Mehta says. 

Add motivation

Kids who resist moving from an activity they prefer to one that they don’t may need extra motivation, Mehta says. It all depends on your child’s specific interests. For example, always listening to your child’s favorite song after toothbrushing may encourage them to brush their teeth. 

Employ timers

Timers are a great way to let kids know how much time they have for activities and when they need to stop. Visual aids for kids with autism can be helpful, Mehta says. An hourglass so kids can see time passing may be useful in helping kids prepare to transition. “That way, five minutes isn’t just some imaginary amount of time,” she says.

Make a social story

Social stories use pictures to create a story about what your child’s day may be like. They can help your child understand the expected steps of a typical day and when they’ll come home. “Social stories help children prepare and know what to expect if they’re starting a new routine,” Mehta says.   

Practice

Mehta suggests giving your child a chance to get to know a new environment before expecting them to spend time there. Ask school staff if you can bring your child to see their classroom and meet their new teachers and staff before the school year starts. You could also ask the teacher to send a photo of the room or where your child will sit, Mehta says.

Use visual cues

Some people respond well to visual reminders, Mehta says. Checklists, pictures and symbols can help cue kids to the next expected step. For example, a visual schedule might show:

• Eat breakfast
• Change our clothes
• Get our backpack ready
• Wait for the bus

“We all use lists to check things off,” Mehta says. “It helps us stay organized and reduces stress. You can use pictures or words, depending on what your child likes.”

Help your child develop coping skills

Transitions may become less challenging over time for some kids with autism. But that’s not because kids outgrow these challenges. “We just build more skills to manage challenges,” Mehta says. “That happens for both neurotypical kids and kids with autism.”

It’s also not unusual for kids’ behavior to change. Your child may struggle with transitions again after managing changes well for a while. 

“There are times when kids will need more practice or support to build different coping skills,” she says. Don’t be afraid to go back to using strategies that worked earlier in your child’s life.

“These tools aren’t just for little kids,” Mehta says. “It’s OK to go back to them if they’re helpful for your child.”

It may also help to talk to other adults who are involved in your child’s care. Mehta says extra support from a caregiver, teacher or therapist can help. “Let them know what your child’s strengths are, where they need support and what strategies have helped at home,” Mehta says.”

Talk to your child’s pediatrician if you see behaviors that concern you or your child seems to be struggling. They can refer you to specialists who can work with you and your child to improve coping skills around transitions. 

Learn more about developmental and behavioral pediatrics at Lurie Children’s.

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