Uncertainty, loss of routine, and insecurity are just some of the emotions likely to affect people with autism over the festive season.
While many will be tucking into the turkey, and ripping off wrapping paper, for those living with the developmental disorder, this time of year can be a far more daunting experience.
Dr Vaughn Price, Principal Clinical Psychologist at Beechwood College, has highlighted how the loss of routine and structure at Christmas can bring confusion and chaos to many people with autism spectrum disorder (ASD).
Vaughn, who has extensively supported patients with ASD throughout his career, says:
“All holiday periods can be a particularly difficult time for people with Autism as the structure and routine that they are familiar with is taken away. Add to this all the ways in which the festive season is different, then there is a lot of uncertainty to deal with. People on the spectrum require a very concrete, literal and predictable world to feel as secure as possible.
“Unfortunately, situations are highly changeable throughout the year, which is particularly true around Christmas time.
“This uncertainty creates ongoing anxiety. It is this anxiety that is at the heart of many issues that people with ASD experience around Christmas.”
In a bid to support those with autism and their families during the challenging festive season Vaughn has offered some timely advice to recognising, planning, and coping with ASD at this time of year.
What common issues might affect someone with autism at Christmas?
“Everyone with ASD is different. However, there are some things that seem to come up a lot for people around this time of year.
“The main issues which have an impact are changes to routine and structure; sensory overload; different social expectations; and irregular social interactions.”
How can families help to minimise any distress?
“To help combat these issues, families can attempt to build structure and daily routine into the festive period. By keeping to routines as much as possible, the person with ASD will find it easier to cope with the sudden influx of change Christmas may bring.
“It’s also essential to map everything out, using visual information to ensure your loved one understands what is happening now, next, that day, and this week.
“If you are planning to go somewhere new, or undertake a new activity, it is important that you prepare ahead of time to reduce uncertainty. Ensure you preview what to expect, what is expected of them, how long it is going to last, and what is coming up next/afterwards.
“It is also essential to never assume anything. Firstly clarify very literally what to expect, and then verify the understanding.
“Preparing thoroughly for change is also key! Give a heads up when moving through the schedule for the day. And inform the person with ASD in enough time so they can adapt to the changing schedule.”
What are the common warning signs or triggers before a potential episode?
“These could include visuals signs of agitation/anger, or they may involve someone dissociating from what’s happening around them or trying to escape, either physically or mentally.”
What can families do to prevent or minimise any issues?
“If this then ascends into a meltdown it is crucial to limit demands on the person and not to talk to them, apart from to ensure they know you are there if they need you.
“Make sure they are safe and everyone else in the vicinity is safe, and reassure them that they are safe. The family’s priority is to support the individual back to a calm space, and to avoid asking questions, arguing or shouting.”
What is the most stressful aspect of Christmas and New Year for someone with autism?
“Sensory overload can be a major issue at this time of year.
“Everyone has subjective sensory experiences, for example what I like to taste, touch, and look at will be different to others. For some people on the spectrum this is magnified hugely: they can have sensory needs that can really impact upon their anxiety/stress etc.
“At Christmas, these can include light – tinsel, Christmas lights, candles; sound – carols, bells, crackers; touch – Christmas jumpers starching, family hugging, excess shoppers.
“There are lots of strange sensory experiences people experience at Christmas, and unless these are made familiar, it could quickly become quite unsettling for someone with ASD.
“Families can gradually expose the person with ASD to these new sensations ahead of Christmas to ensure they are comfortable with them. If there are sensory needs around the person with ASD, it is useful to get an Occupational Therapist’s opinion on the matter, who has worked with ASD.”
Dr Price added: “Plan ahead; if you can predict most of what may happen during the Christmas period, you can prepare and help everyone else to avoid stressful situations or manage them appropriately to minimise anxiety and maximise security.”
Dr Vaughn Price is Principal Clinical Psychologist at Beechwood College, a specialist residential care and further education college in south Wales for young adults between the ages of 16 and 25 with a complex Autistic Spectrum Condition, SEBD needs, as well as moderate, severe and profound learning difficulties. www.lshealthcare.co.uk/beechwood-college