Tuesday, February 4, 2014

Discussion Post - Retreating from Social Events


The scene is all too familiar for many of us. There's a party in your living room, and your child is sitting in their bedroom, away from it all. There's a busy and happy family dinner at the local restaurant, and your child has asked to leave the table for the fourth time. The list could go on and on, the locations change but the reactions and stories stay the same. When Ron wrote "My son is 12 years old, high functioning ASD. He keeps trying to retreat from therapy, lessons and family time by saying he has to go to the bathroom. We were at dinner recently and he went and then asked four more times. He was not sick or anything, just trying to get away. Any ideas on how to work with this," our Facebook fans chimed in with many ideas.

Angelique says: My son was the same. We didn't make a big deal out of it and it stopped. I think he realized that nothing comes out if you go every five minutes so he just stopped going. he still uses it as an avoidance tactic sometimes, but not often. 

Amy says: Is it a puberty thing? He needs a private moment for private things?

Shannon says: I would suggest that it might be anxiety and going to the bathroom could be a way for him to avoid a meltdown or sensory overload. Could also be feeling frustrated or pressured with therapy? Maybe ask him if this is the case and then work on other ways to manage it. I am going through this with my almost 11 year old at the moment.

Linda says: Identify what is overwhelming him (too loud, too crowded, change from routine, etc.) Previewing what will be happening in situation may help. I have used visuals with students that have different options for how they're feeling (For example - I'm confused - I'm not sure what to say - I'm frustrated - etc). They can touch the one(s) that they're feeling and it gives us a starting time for discussion. Make sure he understands how long the situation will last (otherwise, the feeling "FOREVER". Think about how WE feel when in a meeting that does not have a firm end time). Also, give him some control - has the purpose of therapy been explained? can he be given some choice in the different situation - who to sit by, what he can choose to do after participating in expected ways for x amount of time.....

Aspen says: First then Picture cards can be good too. First therapy, then quiet/ alone time etc.

Jill says: Most kids on the spectrum have sensory issues - sometimes unrecognized. He's probably overwhelmed and retreating to the bathroom in his way of giving himself a NEEDED break. I highly recommend reading the blogs of adults on the spectrum to get an idea of what this feels like, and ways to accommodate his need for down time. I think you'll find that if you respect his need to be away, his stress levels will go down and he'll be better equipped to handle the sensory/social demands of things like therapy, meals and lessons - and he'll come back to them when he is able to. I'll look up some links and post in a minute. 

Pat says: I agree with Jill. The restroom is one of the very few places where a person can have complete privacy (unless you're a Mom to young kids!) and EVERY place has a restroom. From the information given, he asks to go and comes back to the activity when he feels ready, even if it is repeatedly, so he is trying. I think you should be proud of his ability to find a solution that works for him and apparently prevents him from having a meltdown. When my husband died young and very unexpectedly, I found myself using this same tactic when I could no longer deal with what was going on around me. Also, as a high-functioning, 12 years old, you can begin to discuss his feelings with him, to help identify whether his feelings at the time are autism related or 12-year old "I don't want to do it" related. 

Evie says: My 12 year old son with high-functioning ASD does this as well. I found he does it more when he is anxious. I reason with him. You can't possibly need to go when you went X minutes ago. You've had nothing to drink to warrant needing to go. When he was younger he would stress himself out that he would actually wet himself. So now I use that as a means to help him as well. Breathe and focus on hanging on. I would make him go before therapy, if he refuses, remind him you won't be letting him go during it and don't.

Melissa says: He may also be hitting puberty.

Melissa B says: Perhaps set a structure that keeps him at tasks but also works in a getaway if he meets certain requirements. Dinner is one hour. You must stay the first 15 minutes, then you may go for five and must stay in 20 minute increments thereafter? Then increase time/decrease away as he readjusts.

Jill shared: Karla Fisher's ASD page has a lot of great visuals designed to help us parents understand issues from and AS point of view. Here's one: https://www.facebook.com/photo.php?fbid=347053362035785&set=a.337556189652169.77809.155369821204141&type=3&theater

Jill followed that up by saying: Pat is right. I would be proud of him that he's figured out a way to self-regulate. Knowing what he needs and figuring out a way to get it is a step toward self-advocacy. Ask him what it is that bother him so much that he needs the breaks. I bet he'll tell you.

Laurie says: I just took my 7 year old son to the doctor yesterday for the same thing. First, check with your ped to rule out a UTI. My son did not have one but there is a condition that is urination frequency and urgency. It is brought on by stress and is a very real feeling. The doctor said not to make a big deal out of it, reduce what stress you can, and let them go as often as needed. It should pass within a few month. Good luck!

Karien says: Just want to say my so is 7 with ds. this is his way of escape with therapy, especially if they challenge him a bit. At first I took him, but now I take him before therapy and tell him he can go again when they're all done.

Our fans, have a lot of great advice. Here's what I've taken away:
- Make sure there isn't a medical problem (like a UTI) causing him to go so frequently. A check-in with your child's primary doctor is probably a good idea to make that distinction.

-Create social stories or first-then picture cards, as the social situations may be too much for the child to handle, or create scenarios where the child is rewarded for achieving chunks of time without asking to leave.

- Know that retreating is often a way of regulating oneself, and since he has language, he is able to ask to leave rather then having a full-scale meltdown.

- Try to get to the root of what is causing your son to want to retreat. Is the activity too hard or too loud? Are the lights there too bright? Are the chairs to hard? Sometimes it is the seemingly smallest things to the parent that make a situation unattainable to someone who processes the world differently.

My own daughter struggles with in-school OT. She has this every Wednesday. She's started to associate the struggles she has with OT tasks with Wednesday and the therapist. She will fake sick, pray for snow and complain about it all. What I discovered was that the skills they are currently working on are incredibly difficult for Little Miss M, and she does not like to fail. She's also battling with having to miss things in class, and resents the therapy for removing her. It's taken a lot of talking, repeating and figuring out reward systems to help her make it through. We're still struggling each week with her avoidance techniques, but because we know why she's avoiding, we are helping her use the correct language to express herself. It's a work in progress.

Don't give up on social situations, but instead, change your expectations. If a lengthy dinner at a restaurant is too much for him, see if you can get him to sit for twenty minutes without retreating. By starting with small chunks, you may be able to work him up to longer time periods. Also, consider tangible rewards for staying at the table or engaged in activity for predetermined amounts of time. For Little Miss M, the knowledge that she may download a new app upon completing our expectations can often be motivation enough to complete an activity.

Thank you to everyone who shared, if there is more you would like to add to the discussion, please add it in the comments section below.

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Amanda was often accused of employing avoidance techniques during that after-dinner clean-up routine while growing up. It should be known, she never purposefully left a situation in order to not clean-up.

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