Dr. Jeffrey Selman, PsyD, BCBA-D, VP, Clinical Services for First Children Services, which serves children with autism spectrum disorder and their families through its STRIVE Autism Care Continuum in New Jersey and Pennsylvania. Dr. Selman discusses below:

• Tips for helping a child with autism cope with routine changes or new activities
• The importance of strict schedules and routines for some kids with autism
• Why changes in routine can cause difficult behaviors for kids with ASD
• How First Children Services’ Board Certified Behavior Analysts (BCBAs) and trained behavior specialists help kids with autism manage behaviors and establish routines through its STRIVE Autism Care Continuum

How Changes in Routine Impact Kids with Autism Spectrum Disorder by
Dr. Jeffrey Selman, PsyD, BCBA-D, VP, Clinical Services for First Children Services, which serves children with autism spectrum disorder and their families through its STRIVE Autism Care Continuum.

1. Tips for helping a child with autism cope with routine changes or new activities:
   Many children have difficulty responding to changes in routine. Humans in general are creatures of habit and change requires effort and energy. For children with autism, it is particularly challenging because the need for sameness helps create predictability and comfort in a world that may otherwise feel overwhelming. Rigidity and inflexible
   adherence to routines is hallmark diagnostic criteria for children on the autism spectrum. When there are changes, even subtle changes, it can be distressing and trigger disruptive behavior, tantrums and anxiety.
2. The importance of strict schedules and routines for some kids with autism:
   It is important to maintain consistent routines and predictable transitions for children with autism. Often times, routines are utilized for parts of the day (e.g., morning routines, evening schedules, etc.), but some individuals benefit from added structure and for tasks to be broken down into shorter increments or steps. Children with autism may have difficulty with receptive and expressive language; therefore, visual schedules with pictures or written directions are encouraged.
3. Why can changes in routine cause difficult behaviors for kids with ASD?
   Transitions can often trigger challenging behavior. Most children present with at least some resistance, often because we are asking kids to end a preferred activity (perhaps video games) to initiate a less preferred activity (dinner time). Challenging behavior may be a result of internal dysregulation (anger, frustration, anxiety, cognitive inflexibility)
   and reinforced behavior. We want to be sure we are giving ample preview and countdown before a transition occurs. Transitions should be highlighted within a more robust schedule for the day, and these moments can be role-played and rehearsed.
   Providing plenty of rewards can help reinforce the desired behavior. Parents, caregivers, and staff working with the child should remember to give specific, in the moment labeled praise. Some children will also benefit from tangible rewards, which can motivate a more positive response.
4. How does First Children Services’ Board Certified Behavior Analysts (BCBAs) and trained behavior specialists help kids with autism manage behaviors and establish routines through its STRIVE Autism Care Continuum?
   Through our STRIVE Autism Care Continuum, First Children Services’ Board Certified Behavior Analysts and clinical staff develop programs for clients that address challenges with transitions and breaks in routine. Programs are delivered in clinical settings and in families’ homes where parents can receive plenty of one-on-one guidance, support and training. It is imperative that kids are exposed to similar structures and programming in multiple environments, and that parents understand how to implement the strategies in a natural, positive and consistent manner.

About First Children Services’ STRIVE Autism Care Continuum:
Part of First Children Services’ integrated care network, the STRIVE Autism Care Continuum is dedicated to improving the lives of children with autism spectrum disorder (ASD) throughout New Jersey and Pennsylvania with treatment plans focusing on increasing communication, social skills and life skills to help children ages 18 months and older maximize their full potential. Operated by premier providers of innovative and evidence-based services, the STRIVE Autism Care Continuum utilizes Applied Behavior Analysis (ABA) therapies to provide every child with customized intervention plans tailored to their skills, needs, interests, preferences, and family situation.

As a community-based provider, First Children Services is committed to expanding access to high quality care and vital support services through its STRIVE Autism Care Continuum as well as a wide range of home, school, and center based therapeutic and educational services to achieve life-changing outcomes for exceptional kids in the communities they serve. To learn more, visit firstchildrenservices.com.