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Supporting Coping Skills at

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This research (project) was supported by an Autism Center of Excellence grant awarded by the National Institute of Child Health and Development (NICHD)
(P50 HD093079)

This project is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under cooperative agreement UA3 MC11054 – Autism
Intervention Research Network on Physical Health. This content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be
inferred by HRSA, HHS or the US Government. This work was conducted through the Autism Speaks Autism Treatment Network serving as the Autism Intervention Research Network on Physical Health.
 ECHO Autism
Agenda
• Reminders
• Introductions
• Didactic
• Discussion
• Case presentation
• Questions and clarifying information
• Wrap up
This research (project) was supported by an Autism Center of Excellence grant awarded by the National Institute of Child Health and Development (NICHD) (P50
HD093079)
 Reminders
• No Protected Health Information
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 Speaker Disclosures
• No Speaker Disclosures
• ECHO Autism is funded by an Autism Center of
Excellence grant awarded by the National
Institute of Child Health and Development
(NICHD) (P50 HD093079)
And is supported by:
• UC Davis Center for Excellence in Developmental
Disabilities
• Northern California Leadership and Education in
Neurodevelopmental Disabilities (LEND) program

ECHO Autism
 Learning Objectives
• Supporting Coping Skills at home
– Key concept review
– What is anxiety?
– Strategies to promote coping:
• Increasing predictability
• Calming routines
• Cognitive strategies

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Key Concept Review

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 What is anxiety?
Fight, flight, or freeze

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 What is Anxiety?
• Physical symptoms

• Worries, intrusive thoughts

• Fear and avoidance

– Specific stimuli/situations
– Future events
– Uncertainty
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Anxiety Serves a Function
There’s a car
Stimuli/ coming!
Whew! I’m
That’s
scared that I
a relief.
Situation might get hit!

Safety/ Anxiety/
Relief Fear

Escape /
Avoidance

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 Anxiety during times of
change and uncertainty
• Stress of uncertainty is to be expected
• We don’t have a mental model of this situation
• Brains are wired with a negative bias
• Fear of change is more common in children with ASD

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 This Photo by Unknown author is licensed under CC BY.

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 Modeling
– How parents and teachers respond to difficult
situations becomes a model for children
– Adults can:
• normalize and validate children’s feelings (e.g.,
fear, worry, frustration)
• model adaptive expression of emotions and coping
skills

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 Triggers and Prevention
• Identifying the trigger gives us clues about prevention
strategies (EBP-ABIs)
Trigger:
Change Prevention Strategies

-When possible, stick to

predictable routines
-Utilize visual work
systems/supports
-Provide a visual schedule with
“Change” incorporated
-Provide Choice
-Provide Visual Supports for
“help” and “break”

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 Increasing Predictability
• Maintain familiar routines

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 Increasing Predictability
• Maintain familiar routines
• Use visual schedules

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 Prepare for change
Share with the caregiver that a change in schedule is
usually okay if the student is prepared!

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 Increase Predictability:
Social Narratives
• Interventions that:
– Describe social situations in some detail
– Highlight relevant cues
– Give examples of appropriate responding
– Individualized according to student needs
• Helping learners
– Adjust to changes in routine
– adapt their behaviors based on the social and physical
cues of a situation
– Learn specific social skills or behaviors.
 Social Stories ™, Carol Grey
• Clearly written stories that paint a picture
of a situation, event or activity
• Used to increase understanding and
identify expectations which can support
the learner in using more appropriate
skills and assist the learner when
responding to situations
 Developing a Story
• It is important to know the specific types of
sentences used when developing a social
narrative.
• According to Carol Gray, there are 7 possible
types of sentences.
– Descriptive (only required sentence)
– Perspective
– Sentences that Coach/Direct (3 types)
– Affirmative
– Partial Sentences

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The Basic Social Story™ Ratio

Number of sentences
that describe,
perspective and/or
affirmative
sentences ≥2
----------------------------
Number of sentences
that coach/direct

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 Other Types of Social
Narratives:
• Power Cards by Elisa
Gagnon
– Power Cards are visual aids
that incorporate a child's
special interest to help
promote an understanding of
social situations, hidden
curriculum items, routines,
organizational skills and
transitions. The Power Card
strategy consists of a script
paired with a Power Card
(Gagnon, 2001).
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 Michael Jordan Practiced His Skills
Michael Jordan was a great basketball player.
Michael was not always the best player. The first
year he tried out, he was cut from his varsity high
school basketball team. Michael Jordan did not
give up. He asked a coach for help. He practiced
his skills every day. He got stronger and smarter.
Front side of card With hard work and practice, Michael Jordan
made the team the next year. He continued to
work hard and practice for his full NBA career.
Michael wants you to know how he succeeded.
1. Even when something you want to do is hard or
you do not succeed DO NOT GIVE UP!
Back side of card 2. Ask a teacher or parent to help you
3. Remember you will get better with practice
4. Make a plan to practice

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 Develop Calming Routines
• Embed into the daily schedule
• Will depend on the interests and
preferences of each student and family
• Identify a location for a “calming corner”
• Start with familiar strategies if possible
• Will need to be taught (and reinforced) like
any new skill

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 Relaxation/Calming Strategies
To Calm the Mind To Calm the Body
• Think about favorite topics • Squeeze a squeeze ball
• Draw • Deep breathing
• Color • Use sensory fidgets or
• Read jokes/preferred books materials (touch, hear, see)
• Sing/Listen to a Song • Yoga and movement
• Count to 20 • Deep pressure or squeezes
• Writing/Journaling • Exercise
• Mindfulness/Meditation • Heavy work

https://teacch.com/resources/teacch-tips/teacch-tip2-relaxation-strategies-routines/

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 Deep breathing

https://teacch.com/resources/teacch-tips/teacch-tip2-relaxation-strategies-routines/

https://www.youtube.com/watch?v=_mZbzDOpylA

https://www.ocali.org/project/resource_galler
y_of_interventions/page/breathing-cards

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 Progressive Muscle
Relaxation
• Hands and Arms: Squeeze Lemons
• Arms and Shoulders: Lazy Cat
• Shoulders and Neck: Turtle
• Jaw: Jawbreaker Bubble Gum
• Stomach: Narrow Fence
• Legs and Feet: Mud Puddle
Ollendick, 1978

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 Mindfulness, Calming, and
Exercise Apps
– Breathe, Think, Do with Sesame (free)
– Daniel Tiger’s Grr-ific Feelings ($2.99)
– HelloMind (free and premium features)
– Mindfulness for Children App ($5.99)
– Calm (free and premium features)- meditation and relaxation
– Headspace (free and premium features)- mindfulness, exercise, and CBT
– SuperBetter (free and premium features- & website)- "gameified" resilience
builder
– Down Dog (free)- yoga
– FitBit Premium or Coach (free for 90 days)- video workouts, sleep tools
– Breathe2Relax (free)
– Pacifica (free)
– RainRain (free)
– Go Noodle (interactive song and dance videos for children)
– Exercise Buddy (2-week free trial)

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 Tolerating Change and
Uncertainty
• Develop scripts or mantras for change
– Rolling with the punches
– Big deal/little deal
– “stretchy brain”

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Bravery Mantras

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Longer-term self-regulation

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 Pay attention to significant
behavior changes
• May be signs that additional mental health
support or referrals are warranted

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Flexibility and Patience is Key
• For students, parents, and providers
• Partner with parents and team

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 Additional Free Resources
• AFIRM Supporting Individuals with Autism through Uncertain Times:
https://afirm.fpg.unc.edu/supporting-individuals-autism-through-uncertain-times
• Fighting the Big Virus coloring book, companion book, and parent guide:
https://piploproductions.com/trinka-and-sam-virus/
• Social Narratives to Support Families During the COVID-19 Crisis:
https://www.ocali.org/project/resource_gallery_of_interventions/page/to-support-families-during-the-
COVID-19-crisis
• Carol Gray Social Stories: Pandemic Social Stories:
https://carolgraysocialstories.com/pandemic-social-stories-direct-access/
• Autism Internet Modules: www.auitsminternetmodules.org
• ATN/AIR-P Strategies to Improve Sleep in Children with Autism:
https://www.autismspeaks.org/tool-kit/atnair-p-strategies-improve-sleep-children-autism
• Practical Strategies for helping children during COVID-19 MIND Institute
Facebook Live: https://www.facebook.com/UCDavisHealth/videos/283687442617467/
• Information For Families with A Child with an Intellectual and/or Developmental
Disability During the Covid-19 Pandemic: https://myemail.constantcontact.com/COVID-
19-Resources-for-Parents-of-Children-with-Intellectual-or-Other-Developmental-
Disabilities.html?soid=1114625386453&aid=7uHDuQO0UDE

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ECHO Autism
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