Routines equal safety for those with autism disorders

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Grace runs out to the playground and goes straight to the water fountain; it doesn't matter to her that it has been turned off for the winter.

Next, she climbs up the stairs of the playground equipment and goes down the swirly slide, then the bumpy slide and finally the small slide.

The play phones are her next stop, first one and then the other metal funnel is visited by her smiling face as she leans over and calls, "Hello, hello, hello" into their cold, unresponsive receptacles.

At last, she runs to the swings, her ultimate destination for recess. Eyes wide, smile broad, she pumps her legs until she appears to be soaring above the bar. This child, who is almost always silent, now sings loudly to the clouds and laughs at the birds.

This isn't just what Grace did today, this is what Grace did yesterday, and last week, and a month ago. I am sure this is what Grace will do tomorrow, next week and probably even next month. It is her routine; she finds comfort and happiness in this repetitive schedule she has created for herself.

"Inflexibility in non-functional routines or rituals," is one of the diagnostic criteria for an autism spectrum disorder.

Is this very different from neurotypical people? Well, yes and no. First, most people would agree it is unusual for a child to stick to such a rigid schedule during recess. Second, most people would also agree they find comfort in their own routines. I know I do.

I have my "getting ready for work" routine, "time for bed" routine, "Sunday morning" routine, even a "this is how I go through the aisles at the grocery store" routine.

So what is the difference? Simple, it all comes down to frequency (how often), intensity (to what degree) and duration (for how long).

For Grace, the frequency of her routines is approximately 3-4 per hour. From the sequence of eating snacks to requesting to use the bathroom at the same times every day, Grace has surrounded herself with comforting routines.

Intensity refers to the minute details that she has created and adheres to. Duration of Grace's routines can be as short as 5 minutes and as long as 30 minutes but added together with the frequency, we find the majority of Grace's day is dominated by routines, and that is just how she likes it.

What causes this need for routine? Believe it or not, it is a need for safety. When you can predict what will happen next, you can prepare and keep yourself safe.

When you have a routine, you can predict what will happen next. Chaos is unpredictable. Chaos is unsafe.

Remember that the biology of a brain affected by an ASD can create a chaotic world. Sensory information is erratic; communication is arduous; social situations are overwhelmingly difficult. So how can an individual, unable to harness the power of language, create a safe haven? Create a routine, a nice, predictable, reliable, safe routine.

From this perspective, it is easier to understand why an individual affected by and ASD is upset when a routine is interrupted, the predictability of the routine has been taken away and with that, the safety.

I get upset when my routine is off to, like no coffee in the morning. But again, it is frequency, intensity and duration of the reaction to change that demonstrates the differences between Grace and I.

I may be grumpy for an hour, snap and the kids, grumble under my breath, but I will get over it.

If Grace is unable to go to recess, she may cry in near hysterics for 45 minutes and been unable to focus on academics or anything else for the rest of the day.

But I understand a change in my routine is annoying and bothersome but to Grace, this change has threatened her safety and made her world an unpredictable scary place.

What can we do? We need to walk a tight rope, for there is comfort in consistency, but growth in change. We need to both honor the need for routines, even help create them if we have to, and work to create some flexibility. Teach children how to deal with change just a little at a time and understand that it certainly isn't easy.

So tomorrow, I will watch Grace check in with the water fountain, slide the slides: 1, 2, 3, call "Hello" to her echo and soar with the birds, serenading the clouds, and I will find comfort and happiness in that routine.

Kathleen Gilmore, a resident of Walla Walla, has taught individuals affected by autism spectrum disorders for more than seven years. She has a master's degree in education and is enrolled in a board certified behavior analyst certification program. She is the founder and president of Eastern Washington Autism Spectrum Disorder Association, a local nonprofit organization dedicated to raising awareness and helping families affected by autism. She can be reached through the group's website at www.ewasda.org.

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