Chapter 4

Enforce Only a Few Rules

As we school our children in the ways of the world, we get the same advice repeatedly: start early. Everything from healthy eating to the value of money must be learned in the womb. Living up to these expectations takes a toll on the kids, let alone the parents, but what’s the alternative?

Have a One-Track Mind

Learning our first language is unlike any other life skill. Not only do we have a hard deadline, but, at only five years of age, the deadline is fast approaching. This makes things simple, if a little intense. When you have a choice, choose to work on combinatorial language and to conserve mental, physical, and emotional resources, both yours and your child’s, for that purpose.

That means letting go of all non-essential parenting for the time being. In the previous chapters we have seen some examples of this, like vocabulary training and watching great children’s shows. Both reasonable but not essential to your child’s mastery of combinatorial language, and are — when we take into account the opportunity cost of these activities — counterproductive.

The same goes for table manners, dress codes, and social graces. The exact boundary will differ from one family to the next, and you will draw your own line in the sand. But the idea is to relax most rules and hold fast to the few that keep your child safe and on track to acquire combinatorial language. In this chapter, we will critically examine your child’s daily routine. Is it possible to release some expectations and bring down the pressure? Alternatively, can we add some structure to save time and effort in the long run?

Mealtimes

As much as we strive to relax and nourish our children with wholesome meals, the opposite often takes place. Mealtimes can invite drama, anxiety, stress, and even physical pain. If this is your case, ask your pediatrician to screen for any discomfort that comes with eating. You could also try to set up a calming routine before meals.

Do not focus on your child's negative behaviors at the table. Instead, create fun conversations about food. Playing with food is not necessarily a bad thing for your child. Allow him to explore and learn about the food and his own senses through play.

Bedtime

Sound sleep is the foundation of our health, learning and growing. It is during deep sleep that our brain consolidates new information into long-term memory. Even more importantly, deep sleep flushes cellular waste out of the brain through cerebrospinal fluid. A buildup of wastes and toxins in the brain has been implicated in a number of neurodegenerative diseases and is the last thing a growing brain needs during the critical period.

Sleep is especially important for your child, because of the mental, emotional and physiological strain of combating autism. Unfortunately, sleep problems are common on the spectrum. According to a 2019 study, nearly 80 percent of autistic children between the ages of 2 and 5 suffer from disrupted sleep.

Any improvement in sleep quality will have far-reaching consequences for your child’s near and remote future. I whole-heartedly support throwing the full weight of your parental authority behind these basic yet effective steps. They’re also an excellent reminder for us, adults, to practice healthy sleep habits.

Physical exertion during the day is the best guarantee of a good night sleep. Give your child plenty of time for vigorous movement indoors and out. Encourage him to go to bed and wake up at the same time every day, weeknights as well as weekends. Create a relaxing nightly routine at least 30 minutes before bedtime. Washing, brushing teeth, and reading a book can all be part of it. Avoid screen time within an hour of bedtime. Keep your child's bedroom cool and dark. If your child takes naps, schedule them early in the day to help him keep regular bedtime hours.

If common sense precautions are not enough, consider the next set of harmless and well researched options to help your child fall and stay asleep.

• White noise. Many autistic children prefer a low consistent background noise to complete silence as they fall asleep. Use a fan or a noise machine to create this effect.
• Weighted blanket. Like a warm hug, a feeling of gentle pressure from a heavy blanket can soothe and comfort your child. Use a traditional boiled wool blanket during cold weather or a breathier version with glass beads sewn inside.
• Melatonin. Some of the genetic mutations that cause autism also interfere with the production of melatonin, a hormone that regulates our sleep cycle. Melatonin is available in supplement form and is a common sleep remedy for both children and adults. The lowest dose should suffice for your child. For very young children, break the tablet into smaller parts. There are no side effects of Melatonin taken in small doses. IMPORTANT: Melatonin helps fall asleep and its effectiveness wears out quickly. It should be given no more than 10 minutes before sleep.
• Ashwagandha root extract. This herbal supplement has a long history of medicinal use. Recent studies support taking ashwagandha to improve brain function, treat insomnia, and relieve anxiety and stress. Melatonin and Ashwagandha can be given together10 minutes before sleep.

Playing Outside

Physical activity is essential to every aspect of your child’s life, from sleep to mood to well-being and learning. Physically active children improve more in all brain functions, including language and cognition.

As you plan your child’s day, don’t forget a healthy dose of fresh air and natural sunlight. A 2018 Taiwanese randomized control study found that spending at least 11 hours a week outdoors during daylight decreased the risk of nearsightedness in young schoolchildren by 54 percent. Even if poor eyesight runs in your family, playing outside makes it significantly less likely that your child will need glasses anytime soon.

Natural sunlight is also an important source of vitamin D. Studies link higher levels of this vitamin to improvement in ASD symptoms, including irritability, hyperactivity, social withdrawal, repetitive hand movements, inappropriate speech, restricted interests, and other stereotypical behaviors. Vitamin D helps increase cognitive awareness, social awareness, and social cognition. Sunlight also triggers the release of endorphins which will make your child happier!

Most of the vitamin D in our bodies is synthesized in the skin when it’s exposed to sunlight. At least 10 minutes a day in the sun with some skin exposed will help your child avoid vitamin D deficiency. In winter months, November through March, go outside around noon when the sun is at its highest. In the summer, do not use sunscreen before 10am and after 4pm. During these hours, the sun is too weak to cause skin damage of any kind, but strong enough to facilitate vitamin D production. Your child can also take vitamin D as a supplement.

Take your child to the playground for several hours each day. In addition to being outdoor gyms, playgrounds offer a chance to find playmates and make new friends. Interacting with other children will boost your child’s language and his self-esteem.

Keep in mind that socializing is a new skill for your child. He may need your direct instructions. Expect teachable moments and consider practicing correct behavior with your child ahead of time. Reward your child's positive actions and focus on the things you want him to do rather than those you don’t want.

Daily Schedule

Our goal is to make daily progress towards language while keeping things as simple as possible for you and your child. How does it work? For many families, the solution is to follow a set schedule every day.

If you don’t have a detailed timetable, I suggest you give it a try. Map out daily activities, like playground, meal and snack times, in 15-minute increments. Plan for learning games, ideally 2-3 times a day, plus playtime to reward your child for his work. Some parents use learning apps as a reward for face-to-face games and exercises. Of course, it only works if your child loves his learning app. The best time for language games is in the morning—but anytime is great for practicing what he’s learned. Use every opportunity throughout the day to ask your child a question or give him a task to complete.

Make a hard copy of the timetable and hang it up where it’s easy to see. Not only will it help you organize your day, but it will double as a communication tool. When your child asks for something he can’t have right away, show him the schedule. A piece of paper posted to the refrigerator door makes a compelling argument for why he should take a nap now and have a snack later. It has saved countless parents untold grief by reassuring a cranky toddler that the treat is coming and life must go as planned.

Change of Pace

Keeping a schedule means switching gears from one activity to the next on cue, and that can be hard for any child. To ease the transition, give your child a timed warning before leaving places and changing activities. This will allow him to feel more in control and will help prevent tantrums or other bad behavior. Use “First ..., then ...” to prepare and reward your child for an unwanted task. For example, “First we will dress, then we will play in the park.”

Between tennis, taekwondo, and swimming lessons, Josh keeps a busy schedule. When it comes to getting his son ready for his activities, Alex’s go-to strategy is timed warning.

“He is attached to rituals. They are bridges over chaos. Sometimes adults stupidly destroy rituals to force the child to behave differently. Rituals are good. They allow him to feel safe. Instead of fighting them, we need to expand them to include the whole world. When Josh needs to stop playing and go somewhere, we have a ritual for that. First, I give a 15-minute warning, then a 10-minute warning. Then I say: ‘We are going in 5 minutes.’ Finally, it’s a 1 minute warning, and by then he’s ready. It’s like a game, and he knows what to expect.”

Tantrums

Sometimes, despite our best efforts, a tantrum is bound to happen. All children experience tantrums from time to time. Stay calm and try to understand what it’s about. Often it’s a simple problem, like a soiled diaper or stomach pain.

If your child throws a tantrum just to get his way, never yield. You absolutely don’t want to reinforce his undesirable behavior. One of the best techniques is to get your child to say three "Yes:"

1. You may want to start by asking if you're hearing your child correctly. For example: "You don't want to go to bed now. Is that right? Yes or no?" The first 'yes' immediately creates a connection because you're saying, 'I'm hearing you'.
2. For the second 'Yes,' you can ask: "You're frustrated right now, aren't you? Yes or no?"
3. For the third "yes," ask: "Where do you feel frustrated in your body right now? Let's see if we can let it go."

That way, you can offer coping mechanisms for your child and help them channel tantrum out of their body.

Another technique is ignoring. It took Ricardo and his wife a few tries to get Rocco to stop throwing tantrums for his favorite treats:

“It was a real nightmare to go to a restaurant. A waiter goes by with a plate of French fries, and all hell breaks loose. A therapist created a plan for us. We cooked French fries at home, and he had to wait until it was time to eat. He cried and peed his pants, but eventually it worked. Now we can go out to eat again.“

Alex believes in walking the fine line between discouraging tantrums and alienating his son:

“The usual advice about tantrums is not to give in. It’s correct, but it doesn’t need to be a religion. When Josh screams, I can see that he feels like he’s a bad boy. It’s important to be on his side even though he can’t have what he wants right now. Usually parents put on stern faces. You can’t put him out in the cold. You need to be with him under any circumstances. When he was little, it was good to give him a hug. He understood that we couldn’t give him what he wanted, but we still loved him.”

When Your Child Can Harm Himself or Others

If your child starts hitting, kicking, biting, or throwing things during a meltdown, stop him immediately and remove him from the place. Make it clear that hurting others is not acceptable. If necessary, take away a privilege or put him in timeout.

If your child tries to hurt himself, do not react emotionally. Do what’s necessary to protect him: restrain him, take away the dangerous object or otherwise block him from doing harm.

When Ricardo realized his son was testing his boundaries during a tantrum, he used the strategy he calls “poker face.”

“He smashed his head into a washing machine and looked to see my reaction. By then I was well trained in ABA, and I ignored him. He never did that again. Had I not put on a poker face, it would have become a routine. The best way to stop him is to show that I don’t care. I block his hands so that he cannot do it again. If he bites himself, I put on my poker face and block him.”

Time-outs and Safe Spaces

Time-outs are a tried and true strategy for dealing with out-of-control toddlers. The trick is to use them sparingly, perhaps to save them for really harmful behavior. The more you use time-outs, the less effective they become.

Consider a safe space as an early alternative to a time-out. A safe space is not a punishment, but rather a place your child enjoys and can choose for himself. You can partner with your child to create a safe space where he can retreat when he feels anxious or overwhelmed. Choose the look and feel your child finds attractive and easy to relax and regroup.

Alex found that he and his son could connect inside a safe space.

“He likes to hide under the blanket. It’s dark there, but some light comes through. He lets his father come under the blanket with him. We sit back to back. He likes to feel protected and not completely alone. Sometimes he even lets more than one person in.”

One of the preschools Josh attended used a tent with stars as a safe space and a time-out. The kids did not fear the time-out, but it did help stop the tantrums and calm them down.

When to Put Your Foot Down

Most families draw their battle lines around personal hygiene and daily schedule. There’s some trial and error involved in setting the rules. And some rules will change over time.

Here’s where Ricardo draws the line:

“Wash hands before meals. Wash hands after peeing. Put your underwear on, can’t go around naked. We gave up on t-shirts. Brush teeth before sleep. This was a real nightmare every day, but we did not give up. A year ago his therapist started a program with steps. Now it’s relatively easy.”

Alex insists his son go to bed at the same time every night. The morning routine was no picnic either, but Alex found a creative solution. He wrote a story about a family who put up a fight every morning when it was time to shower, brush teeth, and go to work. And it was up to a little boy named Josh to set a good example for his unruly parents and older siblings. In the story, not only does Josh do his own part, but he convinces his family to follow the rules. Josh laughed very hard when Alex read him the story. And the morning tantrums gradually went away.

Dear parent, I leave you with one more rule to close the chapter—and the wiki. Take care of yourself. In the words of Ricardo,

“I strongly recommend to parents who are facing the diagnosis to consider your own needs. It’s a marathon, not a sprint. If you put all your efforts into your child, you run the risk of burning yourself out early on. That would be a mistake. You have to take care of yourself. Maybe spare some money for family therapy, as we did. To dry our tears. It is about the family unit, not just one child. If you have other children, what about them? Will they at some point help take care of this child? Don’t rush through the process. Take the time you need to make sure you’re okay.”

Reference

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Games for Development