When we hear the word ‘transition’ in relation to our young adults with additional needs we often think of big changes, maybe like leaving school. It does of course refer to those big life changing events and we will all experience many of those transitions throughout our lives, but ‘transition’ simply means ‘change’ and in this instance I am going to talk about transitioning in terms of moving from one activity or place to another. We all do this numerous times within our day but for people with learning disabilities, autism, ADHD etc these transitions can be very stressful.
Transition, Transition, Transition
Naturally all children will at times resist when asked to pack away their toys because it’s time to go to school, or to do homework or go to bed. Often, they will be unhappy because they were enjoying what they were doing and are being asked to move on to something they may enjoy less. My family will remember I’m sure that my favourite trick when it came to packing away was that I always ‘needed’ to go to the toilet. My aim was that by the time I’d get back the packing away had all been done. My mum soon got wise to that one!! Generally, though children may have a moan and, possibly, a bit of a tantrum but for those with additional needs behaviours may range from a little distress to a full-on meltdown.
Change of any kind can be extremely challenging for some and we need to understand what the triggers are and how we can support them. As I said previously during the course of a normal day we all transition many times. Leaving the house to go out in the car is a transition, arriving at our destination is another transition, being asked to do specific activities throughout the day involves transitions. Returning home again in the evening, performing a task at home then needing to stop this to eat, moving on to bath time etc etc. Numerous transitions every day and many of us are able to adapt to our new setting or task without consciously thinking about it.
My son James often finds transitions difficult. He can get very stressed getting ready to leave the house. We can all be in the hallway getting shoes on and coats out of the cupboard and it all gets too chaotic and stressful for him. He can become very noisy and sometimes quite distressed. The tendency at times like these can be to think that maybe if we sing to James or jolly him along in some way it will help. Actually, what he really needs is quiet, calmness and time to self-regulate whilst at the same time we are going about the things we need to do and giving calm clear reassurance about what we are doing.
Understanding Why Transitions Are Difficult
Why is it so difficult and distressing for some people to transition? Michael Rosenthal, PhD, is a clinical neuropsychologist at the Child Mind Institute in New York. He explains it like this;
“Kids with ADHD have fewer neurons in their rewards centres so they find things throughout their day less rewarding and when they do find something rewarding they tend to hyper-focus on it, ask them to do something less rewarding and you might hit resistance. Research shows that the wiring in the brain centres that are involved in helping children exercise control over their emotions are less developed so you get bigger emotional displays from them compared to those who don’t have ADHD.” Dr Rosenthal goes on to explain “Although transitions can be similarly challenging for those with Autism, their reactions tend to be more extreme, the issue is rooted in a different difficulty. For people with autism the world is an incredibly confusing and overwhelming place so the need for predictability is adaptive. It’s not that the changing of activities is upsetting, it’s that any deviation from routine can feel like the rug is being pulled from under them.” Rosenthal also added that, “those with sensory disorders are prone to dramatic meltdowns and emotional outbursts that they can’t control when they are overwhelmed by unexpected changes.”
The full article from which these quotes are taken can be found here.
How We Can Help
Obviously, knowing James as I do, I have come to anticipate what his triggers may be, but not always. Unfortunately, life is unpredictable and things can happen that I don’t have control over and therefore am unable to prepare James for in advance. Things like the phone ringing when I am in the middle of doing something with him and therefore my attention has to be immediately diverted elsewhere. But, where possible, I try and prepare him for when change is about to happen or we are going to move on to something else.
Tips to help support with transitions
- Give a verbal warning of an activity coming to an end or changing.
When James and I are doing puzzles and I know he needs a pad change I will explain to him that when we have finished this puzzle, I am going to change his pad. He is much more accepting of this than if I just abruptly tell him its changing time without pre warning him.
2. Use a timer where appropriate to demonstrate that it is time to change activity.
A timer can be visual or auditory as required.
3. Build a routine to foster predictability.
A regular routine will encourage anticipation.
4. Try to limit the number of transitions where possible.
If James has followed me upstairs and it’s a suitable time I’ll change him while we are there to save him becoming engaged in something when back downstairs and then having to get him back upstairs again.
5. Give Praise
James responds positively to praise. “Well done, thank-you for helping to put your puzzles away James, now we are ready for lunch”.
6. Use social stories where appropriate.
Helps to encourage familiarity and enforces routine.
7. Communicate clearly to avoid confusion.
Use schedules and now/next boards to support this.
8. Have something familiar if it is comforting.
We see it in young children regularly, they have a comfort blanket. It can be reassuring to have a favourite familiar object with you particularly if you are going to an unfamiliar place (I’m not suggesting it needs to be a blanket).
9. Try to keep something familiar.
In my experience James can sometimes cope with change as long as one thing remains familiar, if there is a change of venue but staff/carers are familiar this is ok or if the venue is familiar but staff/carers are different this may also be ok, but not if both the venue and staff/carers change. That is more than he can cope with.
A friend recently sent me this graphic which I think is quite thought provoking. It is called ‘Tendril Theory’ and was produced by a lady called Erin Human of Human Illustrations. She is a writer, cartoonist and Art Director for Autistic Women & Nonbinary Network (AWN). You can find her writing at eisforerin.com and her thoughts about about Tendril Theory and her original illustration here.
