Learn about tools and strategies for providing therapy in community environments such as recreation centers, job sites, and public spaces. Focus on building independence, social participation, and generalization of skills beyond clinical or educational settings.
Ironically, the reasons why we go to these venues are the reasons people with Autism do not like them! Here are a few challenges that may be faced in public entertainment venues:
Sensory: People with Autism often struggle with sensory input and how to deal with it.
Many of these venues may smell strange (or someone may be wearing perfume) and cause a negative reaction for some people. This can be so subtle that the person with autism may not even know that it is causing him/her to act out of control.
Sudden and loud chaotic noises can cause confusion for them in addition to all the chatter and background music in the room.
Sitting too close to other people can cause unwanted light touch that we know can be very irritating. Speaking of touch, a theatre setting may have textured chairs that are uncomfortable
And not to mention all the visual stimuli that occurs – all the bright lights, some moving and others flashing can put a nervous system into overload.
Social Skills: These venues involve social environments which is an area of real challenge for people with Autism
They may be highly anxious in knowing how to interact with the rest of the group.
As a result they may seem aloof or, on the other hand, blunt.
In an attempt to communicate, they may not be able to read the body language or facial expressions of the other person and then their behavior may appear to be inappropriate.
People with Autism take things very literally which may cause misunderstandings with others at the venue.
Routine and Anxiety: Routine is very important for people with Autism
Going somewhere new outside of routine can cause a lot of anxiety.
Even if a person with Autism is used to going to a venue each week, even the absence of a staff member, different layout, etc. could cause anxiety.
Unexpected events are anxiety producing for them.
Other diagnoses that might experience similar challenges:
We as occupational therapists working with people with developmental disabilities are trained to assess their ability to process sensory information as part of their evaluation.
We are finding that many people with no known diagnoses also have challenges with entertainment venues. Recently, I have been privileged to attend professional baseball games in Baltimore, Philadelphia and San Diego. That venue has changed since I went to baseball games as a child – now there is loud music, flashing lights, huge TV screens and people getting up and stepping on your toes which all make me wonder why I am there. It is challenging for me!
Suggested Solutions
Preparation, Preparation, Preparation:
Social Story: A social story can be a written or visual guide describing various social interactions, situations, behaviors, skills or concepts and were introduced and described by Gray and Garand (1993). They are designed to improve the social skills of people with autism spectrum disorders (ASD). Social stories are used to educate and as praise. Social stories model appropriate social interaction by describing a situation with relevant social cues, other’s perspectives, and a suggested appropriate response. About one half of the time, the stories are used to acknowledge and praise successful completion of an accomplishment. These have been used successfully in preparation for entertainment venues. For further information, Therapro, Inc. offers the Newly Revised Book on Social Stories here.
Sensory Stories: Sensory Stories, published by Therapro, are similar to Social Stories but with the specific approach to teaching children with autism and over-responsive sensory modulation issues to successfully engage in social activities within the home, school, and community. Sensory Stories comprise 30 individual stories about daily activities. These Sensory Stories instruct the child to use calming sensory strategies in order to deal with the unpleasant sensory aspects of that particular situation. When read on a regular basis, Sensory Stories assist the child in developing effective routines to manage the sensory experiences surrounding typical daily activities. The authors have conducted several studies to demonstrate their effectiveness. They can be viewed on the Therapro website.
The Venue Itself
Call ahead and see if the facility has a visual tour for an iPad of the venue. A 360 degree tour to show as much of the rooms, location of bathrooms, etc. would be helpful for knowing the physical layout.
Find out what the venue rules are, how services operates so everyone knows what to expect of the routine
Ask if there could be dedicated time that can be with just families with autism
Would there be a quiet area or small area available for families and individuals who might experience stress during the venue? Here at the Therapro Showroom, we have a sensory area for individuals including a bean bag chair and a basketful of sensory tools. This helps when the parent or caregiver want to look around the showroom. Also, our showroom does not have all products out as that could be overwhelming to individuals. Instead, we ask the parent to make a list of interested products and we go into the warehouse to pick them. Shoppers can sit comfortably at a table and make their decisions as to what they want – no rush.
Helpful Tools During the Venue Visit
Fidgets: During stressful times, fidgets help reduce agitation. Therapro’s selection of fidgets have increased through the years as each nervous system finds a fidget helpful and others offensive. Please see our website for numerous fidgets. Our very popular Fidget Kit includes a variety of fidgets so a person can determine which ones they like or dislike. We have many quiet fidgets that can be used unnoticed!
Additional Tools:
Sensory Strategy Cards: These are small cards with such strategies as “I can grasp my elbows and squeeze hard”, “I can put a heavy backpack or fanny pack in my lap”, “I can do an elbow-check to make sure no one is too close.” They are visual reminders of the various strategies that children can use. They can be tucked in a shirt or pants pocket for a quick reference to a preferred strategy or put on a belt loop or backpack.
On a very snowy Saturday morning on Saturday, January 24, 2014, a small, but strong contingent donned their snow gear and ventured out to Therapro to hear Barbara Sanna Collins, OTR/L’s seminar. Barbara presented her talk, Early Intervention Today, School Tomorrow…What You Need to Know to the audience of therapists, teachers, and child specialists. As the Clinical Director of the Massachusetts Brockton Early Childhood Intervention Program, she adeptly led us through the EI process from eligibility, to programming, and then to preparing for the transition to preschool or other appropriate services when the child “graduates” at the age of three years.
It was astounding to hear that 337,000 children and their families receive early intervention services in the US per year, with 50,000 per year in Massachusetts alone! Barbara updated us on the nitty gritty of how services are paid and how the states differ in their provision of services under Part C of the IDEA federal grant program.
Barbara shared video clips of individual and group treatment sessions in her program that took place at her center as well as at the child’s home. She noted that in the transition to a preschool program, parents who are accustomed to having their hand held through those first 3 years of participation in a program miss this when their child enters the school system – a change from “family focused” services to “child focused” services occurs. The EI team prepares the family and child for this inevitable change in service delivery. At Brockton EI, the team ensures that every child participates in a toddler group before “graduation” so that he/she experiences some typical preschool activities, i.e. transitioning from one activity to another.
Early intervention providers have several unique roles that include the provision of services that help the child with special health care needs reach their highest potential at age three and helping families gain confidence as parents and advocates for their children.
The following testimonials attest to the valuable information Barb presented in her seminar:
“Very informative – A window into the work of EI professionals. Loved the videos of the therapeutic work. Presentation was fantastic!” Marisa G.
“Wonderful presentation. So much good info. Thanks.” Anonymous.
“Very informative and motivating!” Julia H.
“Very informational – I loved the treatment videos!!” Meghan C.
