Autism and the Holiday Season: How to Turn Therapy Challenges into Therapy Opportunities

Every year around this time, I hear the same questions from parents who have a child with autism spectrum disorder (ASD). They’re concerned about how all the festivities and the crowds and the irregular schedules are going to affect their child’s therapy program, and they ask what they can do to make the holidays more joyful and less challenging.

My answer is simple. First, do everything possible to make sure your child’s applied behavior analysis (ABA) therapy schedule is adhered to, and second, look for opportunities to use the holiday disruptions to your child’s advantage.

It’s not that their concerns are groundless, either. In fact, we’re all too aware of what the families of our patients have to deal with this season. Here are just a few examples:

• Changes in routine and disruptions in schedules. One of the biggest holiday challenges is the inconsistency that occurs because of these unavoidable changes that can make even the simplest of things difficult. For example, schools and daycare hours can be different for the holidays. Additionally, challenges can arise because there is more free time than normal.
• The child’s increased excitement and anticipation. The range of novel situations and stimuli—for example, holiday decorations and lights, increased time waiting in lines and running more errands than usual—can both entice and frustrate children with ASD.
• Unexpected challenges. The holidays also bring challenges that are unpredictable. New people and environments are often encountered, leading to stressful situations for children with ASD. For example, more visitors coming to your home or trips to a noisy, brightly lit mall filled with large crowds can be unnerving for him or her.

Supporting your child’s ABA therapy program and incorporating festive activities will help both you and him or her enjoy the holiday season. During the holidays, families with children who have ASD are frequently tempted to cut back on their child’s therapy. But it’s very important that you don‘t do this. Maintaining fidelity to your child’s treatment plan and staying with the prescribed therapy hours—or even increasing them—can mean the difference between holiday cheer and holiday gloom for everyone involved.

At the same time, the holidays can offer more and varied learning opportunities.

Because of the challenges encountered during this time, adhering to your child’s therapeutic program might be difficult so you can replace previously scheduled time with additional therapeutic opportunities.

Incorporate ABA therapy into your holiday traditions

ABA therapy can take place anywhere your child happens to be. It doesn’t have to be in a static location, it can travel with your child. ABA can be used as a teaching tool regardless of where your child is or what time of day it is. Use the holiday time to practice learned skill sets and introduce them into the novel environments your child will be encountering. Going on a shopping expedition provides you with the opportunity to work on learned skills in a new place. For example, you can take advantage of the opportunity to work on delaying impulses to help your child with his or her planning skills or support reinforcement schedules by helping your child sit with Santa.

Increase the opportunity for therapy instead of pulling back

You can also use the new holiday environments to enhance your child’s ABA therapy. For example, having his or her therapist join you on a shopping trip for gifts for siblings is a terrific idea. This will also provide you with the support you may need to help you work on potentially problematic behaviors and help desensitize your child to loud noises, lights or crowds that you’ll most likely encounter. You can use reinforcement and motivation as a way to help maintain the desired behavior in this environment. Also, be flexible in how your child’s treatment is being delivered this time of year. Create more opportunity for structure than what would typically be allocated for your child. Change can be difficult for many children with ASD. Focus on establishing predictability when possible. For example, you can help prepare your child with visual schedules to help reduce the anxiety that abrupt changes can bring about.

Think ahead and when in doubt reference the ABA therapy program

Plan ahead and anticipate what triggers might be lurking in an upcoming environment. Then be sure to provide some accommodations to allow your child to have success. One way to do this is to introduce and prepare your child for novel stimuli and situations before introducing the real life situation. For example, if decorating your house all at once might be overwhelming for your child, instead try putting out a different holiday decoration or do a different thing (like decorating the tree) every day. This helps desensitize your child to the situation.

Maximize skill sets with additional therapy

Understand your child’s strengths and deficits. Plan for independence when applicable and provide support when necessary to avoid failures. For example, understanding delay and the ability to plan are typically difficult concepts for children with ASD. So he or she may want to open presents today because they don’t understand that Christmas isn’t here now or even coming tomorrow. Therapy can help your child understand that Christmas will come and help them prepare for it.

Don’t overlook different venues for staying on track with therapy

Finally, don’t forget that you can also take advantage of center-based ABA therapy for your child. Centers provide you with the opportunity to drop your child off to receive services, when school or daycare is closed and while you’re at work. Receiving center-based services provides your child with consistency in their therapy and generally offers more opportunities for socialization.

Just remember: There’s no need to be the Grinch that stole the holidays… and that you’re not taking the holiday away from your child by maintaining, or even increasing, their therapy program. Keeping your child’s treatment plan on point will help him or her not only enjoy the holiday season but keep them progressing toward their goals. Celebrations and traditions are a special part of the holiday season—one that your child can participate in fully. Take the tips listed above into consideration and talk with your behavior analyst if you have further questions about how to adapt your child’s treatment plan to make the holidays more fun.