Highlighting Choice While Setting Limits

Engaging Children with Autism

Would you like to confidently set limits for your child with autism while maintaining a cooperative interaction?  Can you imagine suggesting a boundary and receiving an agreeable response?   Are you able to refuse a request without suffering a protest, then changing your “no” to a “yes” to keep the peace? Would you like to avoid the accept/reject, yes/no power struggles that so often underpins your caregiving interactions? 

I would like to offer you a choice between teetering on the edge of an autistic child’s melt down and engaging cooperatively with your child while setting limits. All it takes is some imagination and a small switch in your approach when interacting with your child with autism. 

In my book, Understanding the Challenge of “No” for Children with Autism: Improving Communication, Increasing Positivity, Enhancing Relationships.  I discuss the benefits of telling children with autism what “to-do” versus “what “not-to-do.”  For instance, instead of telling a child, “No running,” you would simply say “walking.”  When you tell a child the expected behavior you are providing more concise and accurate information. The child is more easily able to understand the request and respond appropriately. 

Expanding on this concept I would like to introduce you to communicating through Structured Choice.  Structured Choice is a system of offering your child 2-4 simple yet specific choices that give options of items, or activities you are willing to allow in the immediate moment.  For instance, when having lunch, the child would be offered a choice of Juice, Water, or Milk.  The child can pick from any of these options and will enjoy the chosen beverage.  In this example the child was not simply asked, “what do you want to drink?” which might return a response of, “soda.”  This request may not be what the adult wants to allow the child to drink.  The adult and child then enter a conflict negotiation.  The child was also not simply told. “you will drink apple juice today.”  The lack of options may drive the child to feel powerless which leads to protesting and demanding something else in order to engage a sense of significance.  When leading with Structured Choice, three options were offered. Offering different options provides the child the opportunity to engage their personal power by making a choice.  Also, there was no offer of soda or other drink allowing the adult to set and maintained a limit.  The child was happy to choose one of the drinks offered and felt empowered by controlling a small aspect of the lunch menu.  This approach allowed for a limit while avoiding a power struggle.  Both child and adult remain in a positive state of mind and the afternoon remains pleasant. 

Leading as many interactions with autistic children through presenting structured choices provides the foundation for clear communication and cooperative interactions.  Choices can be offered for just about anything you can think of including objects, activities, people, locations, and silly behaviors.  Choices can be offered for pleasurable situations, chores, and even difficult interactions.   The following are a few examples of choices I have offered to children which I found to help set limits while maintaining cooperation.

• Drinks – would you like to drink apple juice, orange juice, or grape juice? Here the drinks are limited to juice and there is no mention of soda or punch or any other option the adult is not willing to provide.
• Toys – “Do you want to play with your doll, puzzle, or markers?” Here the toy choices are all indoor toys.  A limit is set to remain indoors for a while.
• Activities- “We are going to play outside, do you want to play soccer, basketball, or handball?”  This limit is stated.  The offer is for outside play and only 3 activity choices.
• People – “Who would you like to hold hands with while crossing the street Mom, Dad or Brother?”  Again, the limit is stated. The child is expected to hold hands. But, the mental emphasis is on choosing a person to walk with and away from the expectation to hold hands.
• Places – At the park, “Do you want to play on the swings, climbing structure, or sand box?”  Running in the grass is not a choice given. The choices offered limits the child to the playground areas that the caregiver is able to supervise easily.
• Body positions – During a reading activity; “would you like to sit at the table, lay on the floor, or sit in the bean bag chair?”
• Cooperative walking – “While walking through the parking lot, would you like to hold hands, link arms, or hold pinkies?”  This sets the limit of remaining in contact with the adult while focusing on the choice instead of the expectation. 
• Emotional Management – “I can see you are upset.  Would you like to cry on the couch, big chair, or bed?”  This may seem like a strange choice but often children feel supported by the acknowledgement of their emotion, and empowered by the chance to make a choice even as they act out.
• Silly things that help set mood.  “Would you like to walk on tip toes, flap your arms like a bird, or walk normal?” The child is still asked to walk but a playful mood is set to keep the interaction engaging.
• Another silly example – Would you like to clean up your room while listening to music, singing, or making silly noises?  Here the chore is stated but the mood is fun and engaging.

The key elements of leading with Structured Choice include limiting the choices to between two and four options and only offering choices you are prepared honor immediately. Engaging with children through structured choice many times throughout the day will enhance your interactions immensely.  More detailed information on leading with Structured Choice can be found in my book Choice and Structure for Children with Autism: Getting Through the Long Days of Quarantine. I hope you found this information helpful and wish you positive interactions with the children in your life.