Making Mission Plans Gradual for Anxiety Related to Features of Autism

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Given the known challenges kids with autism often have related to sensory sensitivities and/or change from routines, the steps in these mission plans might also have to be more gradual. You will likely need to get creative with your exposure activities in order to have them represent the full range of the anxiety scale.

For example, maybe your child is like Sally and avoids public restrooms. If you find that they rate any variation of entering a public restroom (even with headphones) 8 and above on the anxiety scale, you will need to find something else to start with that is related to the fear, but also falls lower on the anxiety scale. Maybe you will need to start by listening to flushing sounds at a very low volume while at home.

A similar approach could also be used for gradually adjusting to changes in routines. If your child is like Neil and constantly worries about their schedule changing, you might consider using visual symbols on their schedule to let them know that a change is coming soon. The symbol can be anything your child wants, such as a shape, a sticker that they like, or a color, as long as it is meaningful to them. Using visual symbols can be a way to help lower your child’s anxiety by warning them in advance that a change will happen so they can prepare for it.

Getting creative and using audio clips and videos (animated and real) is also a way to ensure there are enough opportunities to practice mission plan steps. For example, if your child is afraid of fireworks, you can use videos of fireworks instead of waiting for Fourth of July or New Year’s Eve to complete a step. Try to experiment with a few options and decide on a mission plan with steps that work for both you and your child.

Making mission plans on fears that overlap with autism characteristics can be trickier than making other mission plans, so don’t get discouraged if you and your child have a hard time at first. Just keep adjusting the mission plan steps until you can figure out what works best for you and your child.

Here is a video of Neil's mission plan on fear of changes.

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Lots of kids have fears or anxiety when there are changes in their routine. Sometimes this gets in the way of doing fun and interesting things, like being with friends, going to new places, and being around new people. For example, Neil is very anxious when his schedule changes. He doesn’t like when he suddenly needs to go somewhere when he is not expecting it, or when his mother drives home from school using a different path or when his dad picks him up. If there is a change, he will ask his parents questions about the new plan over and over and makes sure he knows everything about the plan.

Here are some examples of how Neil and his family can challenge his fear and work towards the goal of Neil being okay with changes in routine when he is notified right before they are happening. They are all examples of exposure activities he can do on a mission plan for anxiety about his schedule changing. The first examples are the easiest for Neil to do, the later ones are harder because they make him feel more anxious.

[Example 1] In the morning, Neil’s mom will tell him that they are making a stop on the way home to his favorite ice cream shop and reminds him when she picks him up. They drive to the ice cream store on their way home from school.

[Example 2] Neil’s mom will remind him when she picks him up that they are stopping at his favorite ice cream shop on the way home. This is the same as the last one, but she does not give a warning in the morning, and proceeds to drive to the ice cream store on their way home from school and get Neil a snack.

[Example 3] Neil’s mother will inform Neil in the morning that they are making a fun special stop on the way home that is different from usual and reminds him when she picks him up. She will not respond to Neil’s questions about where they are going at any time. Instead, she says, “it’s a surprise.” They will stop somewhere that Neil likes on the way home.

[Example 4] Neil’s mother will inform Neil when she picks him up that they are making a fun special stop on the way home that is different from usual. This is the same as the last one, but she does not give a warning in the morning. She will not respond to Neil’s questions about where they are going at any time. They will stop somewhere that Neil likes on the way home, like a park.

[Example 5] Neil’s mother will inform Neil in the morning that they will be driving one of two different ways home. When she picks him up, she reminds him and has him pick a slip of paper out of a bowl. Whatever street is on the slip of paper he picks will be the way they drive home.

[Example 6] Neil’s mother will inform Neil when she picks him up that they will be driving one of two different ways home. This is the same as the last one, but she does not give a warning in the morning. She has him pick a slip of paper out of a bowl. Whatever street is on the slip of paper he picks will be the way they drive home.

[Example 7] Neil’s mother will inform him when she picks him up that they will be driving a new way home.

[Example 8] Neil’s mother will inform him when she picks him up that she needs to run an errand on the way home. Neil will then accompany her on her errand on the way home.

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Making Mission Plans Gradual for Anxiety Related to Features of Autism