Yesterday I introduced you all to Sam.
A day in the life of a child with ASD using the coke can explanation…..
I used the coke can explanation to describe a day at school for Sam, Sam is fictional he is a little boy aged 10, he has red curly hair and a cheeky smile, he is a combination of my own school experiences and that of my children.
The coke can analogy was first described to me by another Autism parent a good few years ago and it has always stuck with me as the perfect way to explain the way a child bottles up everything and then let’s it all go once getting out of school. I have seen other people write about it, this is my interpretation.
In response to my original post I am going to take you back through Sams day making suggestions that I would try to make Sams day more manageable and perhaps even a little enjoyable and fun!
These strategies and suggestions are how I would approach Sam’s difficulties, that doesn’t mean these are the right answers or the only answers, as anyone living with autism knows everyone one on the spectrum is an individual and what helps one person may not help another.
”Come on Sam time to get up”
The light streaming in the curtains burns Sams eyes blinding him.
I would have a blind in Sam’s room that prevents the room being flooded with light when the curtains are first opened to avoid overwhelming Sams eyes.
Sam gets up, Immediately the pressures of every day life are upon him.
get washed and dressed, brush teeth,
go downstairs, join the rest of the family,
Clothes are scratchy and uncomfortable, they are not comfy clothes Sam would choose.
Is it possible for Sam to wear clothing to school that avoids sensory problems?
School’s are required to make reasonable adjustments for children with a disability this includes difficulties around school uniform, allowing a child to wear jogging bottoms and polo shirt in school colours instead of the more traditional shirt, tie and trousers for example.
Seems dig in, or don’t sit right, labels rub and feel different to the rest of clothing they become an annoying distraction for Sam.
Sam tries to eat breakfast but all he can think of is those seems and labels.
Sam is wearing more comfortable clothing and is able to eat a good breakfast.
Sam is calm and ready to start the day.
Sam now now needs to find and put on his shoes and coat,
By making sure Sams coat and shoes are always put away in the same place it will be easier for Sam to know where to look for them.
Shoes are heavy, they squeeze and pinch, feeling tight over Sams feet.
As with clothing is there a more comfortable option for footwear that school would accept? Training shoes in Black for example, compression socks may also help alleviate some sensory difficulties or simply turning an ordinary pair of socks inside out so the seem is to the outside can help.
Coats are restrictive, bulky and annoying!
A fleece and separate thin waterproof might work better but still be as effective as a bulky coat.
Now Sam needs to leave the house.
Sam is ready for school, he still feels a little anxious.
Sam gets in the car, the car is cold, the seats are hard, the car has a funny smell.
Do you really need an air freshener in the car? Could a seat cover help?
The seatbelt digs in and restricts movement, it feels suffocating.
I would give Sam a fidget toy such as a tangle, headphones and iPod, along with a chewey to play with in the car to distract from the discomfort of the seatbelt and to help with sensory processing.
Sam arrives at school, he gets out the car, there are other cars, children and their parents everywhere.
Is there a quiet spot to park the car? Allowing for a more gradual exposure to the different environment?
We park in a quieter spot and enter the playground by the side gate.
So much to see, Where should Sam look?
So much noise, Did someone say Sam?
Perhaps ear defenders or earphones that cancel out noise would help with the transition.
Sam has his earphones on, he is not as overwhelmed by outside sounds.
Where is that noise coming from?
Because Sam is wearing earphones he doesn’t trip on the step because he can concentrate on where he is going.
Sam trips and falls on the steps.
Sam gets up, he feels like running away!
Sam is still a little anxious at going into school.
The noise is the ringing bell, Sam covers his ears and drops to the ground slamming his head off the ground!
Sam is still wearing his earphones as a result the bell ringing doesn’t overwhelm him, he follows the other children into school on time after a reassuring hug.
Sam enters his classroom last, twenty five noisy children each with their own unique faces, sounds and smells, Sams senses are totally overwhelmed, he covers his ears, shuts his eyes and slams his head off the nearest desk.
A voice is shouting “Sam, Sam, sit down Sam, come on now everyone into your seats, “Sam sit down.” All Sam hears is his name. He focuses hard but misses the instructions, he sees the other children sitting down and copies.
Is it possible for Sam to enter school another way where he is able to get into class first?
This would possibly make the transition to the classroom easier, allowing for gradual building exposure to his classmates as they come in, instead of being faced with them all at once.
Sam enters the school ahead of his class, he gets to his classroom first and goes to his visual timetable which is on the wall beside his desk to see what his day looks like. He sees it is maths first and knows he needs to sit at his desk for this lesson. His teacher notices Sam is seated and praises him “Good sitting Sam.”
When giving a child with autism instructions it is really helpful to be as direct as possible, it can be helpful to ensure you have their attention before giving an instruction, for example I would have said to Sam “Sam listening?” Waited a few seconds then said “Sam sitting” I would then wait another few seconds and repeat again “Sam sitting” once Sam was seated I would praise him by saying “Good sitting Sam.”
Chairs are dragging on the floor, like fingernails down a blackboard, the lights are too bright, the classroom is covered in posters and art work made by Childs, pencils on paper make a noise only Sam can hear, it is a busy environment full of distractions. All Sams senses are overwhelmed, Sams eyes and head hurt, Sam wants to run away.
Sam again hits his head off the desk.
An autism friendly classroom would avoid having pictures on the wall within a child’s line of sight. Offer ear defenders to lessen the impact of noise. Do the classroom lights need to be on? Is there enough natural light? Could the bulb in the light nearest Sam be changed for a dimmer one?
Sam is ready to do some work. He has on ear defenders.
Sam tries to do his work.
Sam doesn’t understand what he is meant to be doing, he couldn’t process all the instructions quickly enough. Sam can’t ask for help he can’t communicate his difficulties although Sam is verbal, it is to overwhelming to speak in class.
I would provide Sam with a card to show the teacher with a symbol depicting the need for help, possibly a picture of a hand reaching out, so he/she is aware Sam needs help. I would also leave instructions written on the board so not just Sam but any child could read over them again.
Sam holds up his help card, the teacher goes over and helps Sam to get started on his maths.
Sam rolls his pencil along the table, mesmerised by the way the light dances along it’s straight edges, watching the light dance is soothing for Sam, he gets up and walks around, walking is soothing too, Sam gets told off for distracting the other children he is told to return to his seat.
To avoid this situation I would put in place a time-out card which Sam is allowed to show to his teacher when he needs some time-out of a situation. I would also build in regular movement breaks where Sam is allowed to move around freely in a designated area either within the classroom or just outside. Suggestions for movement that may help Sam reregulate his senses include shooting a ball in a hoop, bouncing on a trampet or running on the spot.
Sam takes a planned movement break of five minutes then completes his work.
Break time! Sam is alone, the other children won’t include him. Over 100 children in the playground but Sam feels so lonely, he longs for company. Again Sam is hit with sensory overload caused by the noisy playground environment, Sam covers his ears falls to the ground and hammers his head off the ground.
“Go play Sam”
Play? How do I play? What with? There are no toys, are the thoughts racing through Sams mind.
Sam doesn’t know how to play he struggles with imagination,
Play with who? Sam has no friends.
To avoid the isolation of any child in any school I would have in place regular sessions accross all year groups where acceptance and inclusion of all is taught and demonstrated. I would ensure the whole school was aware and accepting of autism. I would reward children who demonstrated these values with house points and certificates to encourage everyone to join in.
In the playground I would provide activities that encouraged all children to play. For example balls, hoops, skipping ropes, bean bags etc. I would have an are set aside for football and an area for free running. Supervising staff would know what children would need some support like Sam will and see that they receive the help they need.
Sam runs up and down, knocking into other children, “ Go away Sam!” “You are in the way Sam”
Sam comes out for break, he doesn’t bang his head off the playground floor because due to feeling less stressed in his morning routine so far he is not so overwhelmed at the different environment, because there are things for Sam to play with and areas he can run freely Sam looks forward to break times, he doesn’t get in the way, other children encourage Sam to join in their games.
The smell and noise in the dining room at lunchtime causes Sam to retch, he then falls to the ground hands on ears, eyes screwed tightly shut, slamming his head off the floor, his senses overwhelmed again. Sam barely eats any lunch.
I would find Sam somewhere less overwhelming to eat lunch. Or sit him at a table as far away from where the food is served as possible.
Sam eats his lunch at the table beside the canteen door, next to an open window that lets in fresh air.
“Do your worksheet Sam!”
Again using a visual timetable with Sam will help him to understand what he is meant to be doing and if he needs help Sam has a way of asking using his help card.
Gym time, Sam is last to change, it is hard for Sam to change clothes, he is all fingers and thumbs, his PE kit feels different, different materials. More labels. Light shoes that feel wrong.
Sam is able to change quicker because he is wearing clothes which are comfortable with less buttons and fastenings. He still doesn’t like the change in feelings between his school clothes and PE kit but tolerates this better due to it having been easier to change.
At PE, no one wants Sam on their team, Sam can’t hit the ball with the bat, he gets struck out, he sits alone at the side punching his chin.
To avoid this situation I would either have the teacher pick teams or have a system where children pick names form a hat in turns. I would hope with proper autism awareness and acceptance within a school a child like Sam would not be left out. I would also consider the needs of all the children within a class and look to choose activities that wouldn’t emphasise difficulties.
Sam goes to PE, his teacher splits the class into two teams and they play a version of basketball Sam is good at getting the ball in the hoop.
Sam changes back into his school clothes, again everything feels wrong.
Sam changed back into his comfortable clothes having enjoyed running about at PE.
“Come on Sam everyone else has finished that worksheet!” Sam flaps his arms and stamps his feet. Sam is struggling to hide his autism.
Sam wants to run away, he feels sweaty, his heart is thundering in his chest, the classroom is too hot, too loud, too bright, just all too much! Sam sits repeatedly banging his head off his desk.
Sam doesn’t understand, Sam needs to move, too fidget, Sam chews his fingers, the bones in his fingers are deformed from repetitive chewing.
Sam on returning from PE was able to look at his visual timetable and knew he was meant to be doing a worksheet, he was able to finish at the same time as everyone else, he feels calm.
Assembly, “Sit down Sam!”
Sam just can’t sit still, Sam just can’t keep quiet. Too many people, everywhere, it is all too much!
Smash, Smash, smash! Sam is smashing his head off the tiled floor.
Sam starts making primal noises, squealing, howling like a wolf, feet stamping, arms flapping.
Children whisper, teachers talking, it is all too much, more head smashing. Sam is crying.
“Sam back to the classroom” Sam stands up, he doesn’t understand why he has to leave and is guided back to the classroom everyone is staring, pointing, whispering “weirdo, freak, cry baby” Sam understands every single insult, the tears fall faster.
I would suggest allowing Sam to sit at the end of a row, so he can easily leave if he needs to, I would make sure he had a chewey and fidget toy along with ear defenders.
Sam finds assemblies difficult, his teacher is aware of this and sits Sam near the door, Sam has his chewey he chews on and his fidget toy, when he starts to feel overwhelmed he is able to show his time-out card and leave quietly without the others noticing and heads back to his time-out space to bounce on the trampet.
Sam is back at his desk drawing when the rest of the class returns from assembly, he looks at the visual timetable and sees it is home time.
“Sam get your coat and bag”
Sam can’t find his coat and what else was he to find….
Sam gets knocked into, pushed out the way, Sam returns with his coat,
“Sam where is your bag?”
Sam goes back into the cloakroom, more pushing and shoving to find his bag Sam’s bag is not on its peg someone has moved it, Sam is panicking, finally he finds his bag hidden out of sight over by the door.
Sam’s coat and bag are on his peg, his teacher sends the children in small groups to collect their things to avoid pushing in the cloakroom, Sam finds his things easily.
Hometime! Sam negotiates his way along a packed corridor full of a sea of moving children. He fights his way through the door outside into the playground to be met by the faces of 100’s of parents waiting to collect their children, Sam spots me.
“How was your day Sam?”
Sam’s class are escorted to the door by the teacher to minimise pushing, I would be standing in the same spot as I do everyday so Sam knows where to meet me. Sam still needs to let off some steam as do most children after school but the risk of mealtdown is minimal because Sam has had a day at school where his needs were thought about understood and supported.
I hope in taking you back through Sams day is helpful in demonstrating that small easily implemented changes can make a huge difference to children like Sam they also help children without additional needs be understanding and accepting.