Steps for Making a Plan of Action

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Step 1: Choose the First Fear, Anxiety, or Worry You Want to Tackle

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The first step to creating a plan of action is deciding which fear to work on first. Look at the Fears and Worries Checklist you and your child filled out back in Module 1. Consider how both you and your child’s lives are impacted by each of these fears. For example, some children are so afraid of interacting with others that they refuse to go to school or avoid activities that they would likely enjoy. Additionally, some caregivers may find themselves sleeping in their child’s room every night due to their child’s anxiety. We suggest that you choose to work on a fear or worry that causes a lot of problems for you and your child.

Your child will be asked to write about their first target fear or worry while considering the following questions:

Are you motivated to overcome this fear?
Has this fear ever stopped you from doing something you wanted or needed to do?
Think of some times where you felt this fear. What happened?

While deciding which fear to target first, it may be helpful for you as the caregiver to consider the above questions as well.

Once you and your child have decided what fear to tackle, write down the fear you chose at the top of the My Plan of Action worksheet.

Here are some main guidelines to consider when choosing the first fear:

How clear is it – are there clear and straightforward possibilities for steps your child can take to face this fear?
Frequency – will there be frequent opportunities to practice facing this fear?
Importance – are you and/or your child motivated to get over this fear?

Social Skills

Social skills are a known area of difficulty for many autistic individuals. If your autistic child or teen does not initiate or engage in social interactions, this may simply mean that your child is not that interested in interacting with others. It could also mean that they do not have the social skills or understanding needed to engage socially.

However, for autistic youth who are interested in social interactions and want to engage with others, social avoidance or withdrawal may be signs of social anxiety. Socially anxious youth may have fears of being judged or rejected, or if they are confused by social situations, they may have fears about saying or doing the wrong thing or behaving inappropriately in situations they do not understand.

Targeting social fears and worries with a plan of action can be a great idea. But before targeting social fears, some children may require extra preparation or coaching in social skills from you or another trusted adult. Later on in the program, you will have the option of working through a supplemental module to help your child with their social skills so they can be better prepared to face social fears and worries.

Sensory Sensitivities

Many autistic individuals struggle with sensory sensitivities and can become easily overstimulated and overwhelmed by things in their external environment. It makes sense that these individuals often try to avoid situations or things that cause them to be overstimulated. For example, not eating a certain food, avoiding loud and crowded places, or never wearing clothing with tags or collars may all be due to sensory sensitivities. This kind of avoidance is not anxiety related and should not be targets for a plan of action.

But sometimes, autistic individuals may develop anxiety about their sensory sensitivities or worry too much about becoming overstimulated. For instance, George has developed a fear of the mall and refuses to go. This is because George once became extremely overstimulated at a mall, and he has not gone back since then. During this time, his fear of the mall has only gotten worse.

George and his mom may want to create a plan of action for George’s fear of the mall, but this should probably not be their first plan of action. Because sensory issues are involved, this fear is bit more complicated to target, and George may need to use coping tools like noise canceling headphones to help him face this fear.

Sensory sensitivities are a core feature of autism, and core features of autism cannot be changed. However, the anxiety associated with George’s sensory sensitivities can be overcome.

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Step 2: Choose a Specific Goal You Want to Reach Based on the Anxiety You Chose

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You have just picked the anxiety that your child will work on in their first plan of action. Now, you need to choose a specific goal. The goal for a plan of action should be a specific behavior, activity, or ability that your child can aim for. It should be something you would like your child to be able to do by the end of their plan, such as “give a presentation in front of my class at school”. You may get some ideas from the writing exercise your child completed in step one, or from the goals worksheet you completed in Module 1.

Once you have chosen a goal, write it down at the top of your My Plan of Action worksheet and write it again at the very bottom of the worksheet.

Here are some guidelines to keep in mind when choosing a specific goal:

Make sure it corresponds to the anxiety that the plan of action is for and make sure it represents that your child has overcome this anxiety.
- A plan of action for a fear of dogs may have a goal such as “Spend a whole day in my sister’s apartment with her two black labs”.
The goal should be measurable and specific enough for you and your child to know once that goal has been accomplished.
Make sure the goal is practical and achievable for your child.

Step 3: Brainstorm Different Steps or Exposure Activities to Complete

Remember, a plan of action is gradual. We do not expect your child to wake up tomorrow and achieve the goal you wrote down in step two. A plan of action is made up of small steps or activities that will help your child work up to their goal activity. Each step in the plan is a little bit harder than the one before it, bringing your child closer to completing their final goal. There is no set number of activities required for a plan of action, but the activities should cover the whole span of the anxiety intensity scale (from 1 or 2 all the way up to 10).

Here are some tips to help your child create activities for their plan of action (View a PDF version).

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When coming up with possible steps or activities for a plan of action, try to choose things that your child will be able to practice multiple times a week. Also, try choosing things that are within your control if possible. For example, an activity like “stand on the porch under the awning while it is raining” would be great for a plan of action targeting a fear of storms. But if it rarely rains where you live, it might not be the best activity to choose. It would be important to list several other activities your child may be able to practice more often.

When thinking about how to make easier and harder activities, consider the following factors.

Who is involved in the activity (number of people, age, gender, level of familiarity)?
How long does the activity last? What amount of time is your child required to spend in a situation?
Where will it occur?
How much preparation will occur prior to the activity?
How intense or prevalent is the feared item or situation in this activity?

A few of the activities in your plan of action will likely be variations of the same task or situation, so it’s also important to be specific when coming up with activities. Details such as those in the bullet points above should be included so that it’s very clear what each activity requires.

Once you have a list of possible activities for your child’s plan of action, read back through them to make sure they all relate to the same fear, are specific enough, and are doable for your child.

Here are some ideas for plan of action exposure activities for different fears. Feel free to adapt them for your child’s anxiety or use them as inspiration.

A note: Some fears may require you to get creative. With fears related to making mistakes, for example, ideas for activities might not be intuitive. This is why we encourage you to start with a more concrete fear. We have some tips for coming up with creative exposure activities and plans in later modules.

Step 4: Give Each Exposure Activity a Rating Using the Anxiety Intensity Scale

After coming up with a list of possible activities, your child will use the anxiety intensity scale to rate the activities. As a reminder, a rating of 0 means that the activity does not scare your child at all, and a rating of 10 means that the activity is the scariest thing your child could do. Look back at the plan of action examples from Sophia and George to see how they rated their exposure activities.

Step 5: Order the Activities from Least to Most Scary

After your child has given all of the possible activities in your list a rating, you will then need to order the activities from least to most scary. The activity that gives your child the most anxiety should come last. This activity could serve as the goal activity for the plan of action, or if you have already determined a goal activity, it would come right before the goal. It might be helpful to transfer the activities onto post its or notecards for this process, so they are easy to arrange as you develop your plan of action.

As you complete steps 4 and 5, you might find out that the activities you came up with are all rated the same levels on the anxiety intensity scale, or you might find out that the activities do not span across every level on the scale (1 – 10). It is okay if you have a lot of different activities at the same level on the scale! Switching up the ways your child faces a certain fear will help them learn. But you will still need to make sure you have activities that are easier for your child (ranging from levels 1 – 4), and harder for your child (ranging from levels 5 – 10). If needed, go back and brainstorm some new activities to make sure your plan of action will help your child gradually complete harder and harder activities. Also, it is completely okay to eliminate some activities during this process as well.

It might be hard for your child to accurately report their level of anxiety for a given situation- especially when they have to guess without actually being in that situation. If your child has had some trouble using the anxiety intensity scale, try using the following method instead to order the exposure activities:

First, transfer the activities onto note cards or slips of paper and order the activities based on which ones you think would be the easiest or hardest for your child.
Then, hold up the first two activities in the list and ask your child which one would be harder. Adjust the order as necessary based on your child’s response and continue this process with the next two activities in the list.

Once you and your child have put the activities in order of difficulty, reflect on the entire plan of action and make sure that no two activities in a row would be too big of a jump. For example, if the first two activities are rated 1 and 2 on the anxiety intensity scale and the next one is a 6, this would be too big of a jump. Also, make sure the first activity in the plan is something your child could try today or tomorrow. The first steps should be fairly easy for your child- it is important to experience success at the beginning while learning this process. This will give your child confidence in their abilities and motivate them to tackle harder activities!

You do not need to follow a plan of action perfectly in order; in fact, you should feel free to make changes as you and your child learn more about how they face their fears. If switching up a goal, jumping around to different steps or going back to an earlier step will help your child reach their goal, go for it!

Step 6: Choose a Motivation Booster for Each Activity OR Decide How Many Points Each Activity is Worth

It is difficult to face your fears, so rewards will be helpful for your child as they complete the activities in their plan of action. Your child should be rewarded for each exposure activity they complete in their plan.

Look back at the Motivation Booster worksheet you filled out in Module 2. If your child would like to be rewarded with points, then work with them to decide how many points they will get for completing each activity in the plan of action. Write the number of points and exposure activities down on this worksheet: My Plan of Action + Points. As a reminder, rewards should match the effort your child put into the activity. You should award the most points to the activity with the highest anxiety rating, and the least points to the activity with the lowest anxiety rating.

If you and your child choose not to use points, then work with them to decide what motivation booster they will get for completing each activity. Write the motivation boosters and exposure activities down on this worksheet: My Plan of Action + Motivation Boosters. You should assign the biggest motivation booster to the activity with the highest anxiety rating and the smallest motivation booster to the activity with the lowest anxiety rating.

Here are some examples from Sophia’s Plan of Action: