Autism Series to Support Strategies: Choice Making, Routines, Preparation, and Understanding Stims

Supporting a child with Autism Spectrum Disorder (ASD) requires patience, planning, and an understanding of their unique ways of interacting with the world. From making choices to following routines, managing stims, and preparing for transitions, these strategies build independence, communication skills, and social competence. This comprehensive guide explores effective approaches to help children with ASD thrive in daily life and social situations.

The Power of Choice Making for Children with Autism

Every day, children make countless decisions, from what to eat to which activity to pursue. Children with developmental delays or those on the autism spectrum may struggle to communicate their choices or make decisions independently. Teaching choice-making skills is critical to building communication, independence, and social behaviors in children with ASD.

Scenario 1: Communicating Needs Through Choices

Imagine a young child moving to the fridge, tugging at a parent, and crying when asked what they want. Traditional communication breaks down in this scenario. Parents may guess what the child wants, but this can cause frustration or meltdowns.

Strategies to Use Choices for Communication:

1. Provide Simple Choices – Show two options, such as a biscuit and an apple, allowing the child to indicate their preference. Limiting choices helps prevent confusion.

2. Use Visual Supports – Visual choice boards with pictures, objects, or photos improve focus and comprehension.

3. Teach the Child How to Choose – Show the child how to point, pick up an object, or indicate their preference verbally.

4. Create Opportunities – Encourage choice-making during mealtime, bath time, or other daily routines. Visual aids benefit both non-verbal and verbal children, enhancing clarity in communication.

By learning to make choices, children gain a sense of control over their environment, reducing frustration and supporting better social skills and behavior.

Scenario 2: Building Independence Through Choices

Independence is another key benefit of teaching choice-making. For instance, a child may need step-by-step guidance to brush teeth, choose clothes, or comb hair. Visual choice boards can assist in completing tasks with minimal adult intervention.

Practical Applications of Visual Choices:

• Daily Routines – Choices for clothes, shoes, and activities can reduce confusion and increase self-reliance.

• Activity Planning – Children can decide on the next game or worksheet during free time, fostering decision-making skills.

• Understanding Big vs. Small Decisions – Small decisions, like selecting an activity, can be made independently, while guidance can be provided for more complex decisions.

Visual strategies not only improve task completion but also nurture problem-solving and prioritization skills.

Scenario 3: Social Skills and Behavioral Choices

Social interactions can be challenging, especially when children experience negative outcomes, such as losing a game. A child may meltdown due to frustration, leaving peers uncertain how to respond.

Steps to Teach Social Choices:

1. Understanding Outcomes – Use role-playing to demonstrate winning and losing scenarios. Discuss emotions associated with outcomes.

2. Teaching Socially Appropriate Reactions – Visual choice cards can show two possible emotional responses, such as “I am sad, let’s play again” versus “kicking the board.”

3. Practice and Repetition – Revisit situations and model choices regularly to help children internalize appropriate responses.

Through structured guidance, children learn to manage emotions, interact socially, and develop coping mechanisms, leading to improved behavior and stronger relationships with peers.

Understanding and Managing Stims in Autism

Stimming, or self-stimulatory behavior, is a hallmark of ASD and other disorders such as anxiety, OCD, and Tourette’s. These repetitive behaviors, movements, or sounds help individuals regulate sensory input and manage their environment.

What Are Stims?

Stims are considered socially inappropriate and irrelevant. The degree of stimming would vary based on the type of disorder, its severity and/ or the sensory need/ difference the individual has. Each one of us may ‘stim’ in our own way. For instance, when I am in deep thought – I may twirl may hair with my finger or drum my fingers on a table. This seems harmless and often goes unnoticed by my family members or friends surrounding me.

• Visual Stims – Watching lights or moving objects repeatedly.

• Verbal Stims – Repeating songs, phrases, or humming for comfort.

• Tactile Stims – Touching soft textures or hugging objects.

• Proprioceptive or Sensory Stims – Rocking, spinning, or other body movements to process sensory input.

• Taste and Smell Stims – Exploring objects through mouth or smell for sensory satisfaction.

Some stims are mild, like humming quietly, while others can be vigorous or harmful, such as head-banging or biting.

Why Do Individuals with ASD Stim?

Stims are often linked to sensory processing differences. Children with ASD may experience:

• Overstimulation from environmental sights, sounds, or textures.

• Understimulation, requiring movement or tactile input to self-regulate.

• Anxiety or stress, prompting repetitive behaviors to regain control.

Stimming allows children to cope with sensory input and emotional stress. Just like a neurotypical person might tap a foot or pace when anxious, stims serve as a natural coping mechanism for children with ASD.

Supporting Children with Stims

Attempting to stop all stimming is neither effective nor advisable. Instead, caregivers and therapists should focus on safe, structured approaches:

1. Assess Sensory Needs – Occupational therapy or sensory integration therapy can identify triggers and provide tailored interventions.

2. Calm the Environment – Reduce overstimulation, provide familiar objects, or allow safe completion of the stim.

3. Promote Safe or Socially Appropriate Stims – Use fidget toys or other alternatives to redirect vigorous behaviors.

4. Use Social Stories – Help children understand when and where stimming is appropriate.

Through these approaches, stimming can be accommodated, reduced in socially inappropriate contexts, and understood as a meaningful tool for self-regulation.

The Importance of Routine for Children with Autism

Routine provides structure, predictability, and a sense of security for children with ASD. Changes or transitions can be stressful due to sensory sensitivities or difficulty anticipating events.

Establishing Effective Routines

• Minimize Transitions – Keep activities consistent to reduce anxiety.

• Prepare for Changes – Warn the child in advance about upcoming changes.

• Provide Familiar Support – A familiar adult can help the child navigate unexpected transitions.

Managing Weekday and Weekend Routines

• Weekdays can be structured around school, therapy sessions, and activities.

• Weekends may have more flexibility but should maintain familiar patterns to avoid stress.

Routine Within Sessions

• Start and end sessions with familiar activities.

• Clearly outline what the child will be doing.

• Reinforce transitions through repetition and cues.

Strategies for Smooth Transitions

1. Verbal Cues – Simple, clear sentences about upcoming transitions, repeated at each step.

2. Visual Cues – Picture schedules, charts, and progress indicators to guide activities.

3. Auditory Cues – Bells, claps, or verbal prompts to indicate transitions.

Consistency in strategies helps children anticipate changes, reducing anxiety and improving cooperation.

The Power of Preparation for ASD Support

Preparation is an essential strategy for managing daily activities, therapy sessions, and social interactions. It reduces stress, improves compliance, and enhances independence.

Preparation Through Calendars

Visual calendars highlight key events, appointments, and changes in routine. Simple images or symbols can communicate important information effectively.

Home-Based Preparation

• Where – A comfortable, familiar space ensures focus.

• When – Prepare children before events or tasks, such as therapy sessions or outings.

• Who – Initially, the most familiar caregiver should guide preparation, with support from family members as skills develop.

Preparing for School and Therapy

• Coordinate between parents and teachers/therapists for consistent messaging.

• Use the same visuals and verbal cues to reinforce expectations.

• Include reinforcers like stickers or praise to motivate the child.

Preparing “On the Go”

• Use portable tools such as phones, tablets, laminated pictures, or whiteboards.

• Show visual cues of destinations, tasks, and activities to reduce anxiety.

• Simple apps can provide choices and guide the child through schedules.

Promoting Independence Through Preparation

• Gradually involve the child in planning tasks.

• Encourage choice-making within schedules.

• Use stories to help the child anticipate steps in daily routines.

By fostering preparation skills, children with ASD learn to manage transitions, participate in activities confidently, and gradually assume more independence.

Integrating All Strategies: Choice, Routine, Stimming, and Preparation

When supporting a child with ASD, combining these strategies creates a cohesive framework:

• Choice Making enhances communication, independence, and social behaviors.

• Understanding Stims allows caregivers to provide safe self-regulation opportunities.

• Structured Routines reduce anxiety and improve engagement.

• Preparation Strategies smooth transitions and promote autonomy.

Implementing these approaches requires patience, consistency, and close collaboration between parents, therapists, and educators. With these supports in place, children with ASD can thrive in daily life, school, and social settings.

Conclusion

Supporting children with Autism Spectrum Disorder is a multi-faceted endeavor. Teaching choice-making, respecting and managing stims, maintaining structured routines, and preparing children for transitions all contribute to improved communication, independence, and social skills. Every child is unique, so strategies must be individualized, consistent, and implemented with care.

By understanding the child’s needs, collaborating with professionals, and using structured interventions, caregivers can empower children with ASD to navigate their world confidently and successfully.