The HealthE6 Model™ developed at The Center for Discovery outlines six pillars related to health and functioning for individuals with autism and other disabilities. The first four elements of the HealthE6 model include environment, energy regulation, eating and nutrition, and emotional regulation. Strategies in these lifestyle areas are designed to reduce stress, decrease maladaptive behaviors, and increase prosocial behaviors. The HealthE6 model can be applied to ensure a happier and healthier holiday for your child with autism and your family.
Changes to the environment during the holidays can be especially difficult for those with autism spectrum disorder (ASD). Holidays can mean visitors to the house, going to unfamiliar places, along with parties that include a large crowd. Such situations are challenging for those with ASD who can experience social anxiety, as well as sensory sensitivities. Vacations and other holiday events also mean a change in routine or schedule, which can be stressful. The following environmental strategies can be helpful around the holidays:
- Prepare social stories that describe what will be happening and what behavior is expected. Review these stories ahead of time.
- Review pictures of extended family members or other guests who may be coming to the home. Explain the relationships and what type of behavior is appropriate given the relationship. For example, a hug and a kiss is fine for grandma, but not the neighbor from down the street.
- Develop a written or picture schedule of activities and review this schedule throughout the day.
- Brief family members and guests on how you plan to manage challenging behavior prior to a gathering. For example, you could explain that you may have to leave suddenly, that it is best that others leave the immediate area, or that you will ask for help if needed.
- Shorten the length of gatherings to keep them successful. Bring along highly preferred activities to keep your child engaged. Ask the hosts if they could designate a “calm space” where your son or daughter can go throughout the visit to prevent becoming overwhelmed or to de-escalate, should a problem occur.
Exercise and sleep are key components for energy regulation. Holidays activities can be sedentary and changes in schedules can negatively impact sleep. The following energy regulation strategies can be helpful during the holidays:
- Try not to deviate more than an hour from typical bedtimes and awake times on weekends and vacation days. Going to bed late or sleeping in makes it hard to get back on track and can result in overall dysregulation.
- Plan activities that involve movement. If safe for your child, take a walk to look at holiday decorations or take a hike in the woods. Don’t just listen to holiday music, dance to the music! Have your child assist with bringing in shopping bags from the car or carrying boxes of decorations. Plan a holiday scavenger hunt. These are just a few ideas to get up and moving.
Holidays are all about food! Overeating is often the norm. Unfortunately, changes in eating habits can be problematic for those with ASD, many of whom also have gastrointestinal issues. Dietary changes can result in stomach pain or discomfort, which can lead to challenging behaviors. Some children with ASD are selective eaters. This can make holiday parties difficult if favorite foods are not available. Here are some suggestions for managing eating during the holidays:
- Make special treats that contain ingredients your child can usually tolerate. Bring these to holiday gatherings for your child and to share with others!
- Keep mealtimes as consistent as possible. Eat at the usual times using the typical routine.
- Don’t use holiday parties as a time to push your child to try new foods. Parties are likely already stressful enough. Bring a preferred meal in case your child refuses what is being served.
- You may want to explain to hosts ahead of time that your child may prefer to eat his/her favorite food or at a different time to keep with a typical schedule.
Holidays can bring on both positive and negative emotions. Here are some ways to help with emotional regulation:
- Allow your child frequent breaks in calm and quiet locations. Don’t overschedule.
- Provide choices as much as possible.
- At the top of every hour take a few moments to relax. For example, encourage your child to take 10 deep breaths, practice tensing and releasing muscles, provide a hand massage, or take a quick movement break.
- Explain your emotions to your child and help them understand their own. For negative emotions, develop a plan for what to do to return to a more positive frame of mind. For example, when your child is frustrated, they can take a break or ask for help.
Written by Johanna Lantz, Ph.D., BCBA, Chief of Psychology at The Center for Discovery.
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