How Can You Assess Stressors

A key ingredient to a successful stress reduction program is the proactive identification of stressful situations for the person with ASD. The Stress Survey Schedule for Individuals with Autism and Other Pervasive Developmental Disabilities (Groden, J. et al. 1999) is an easy checklist for parents, teachers or other caregivers to fill out. The assessment tool sorts stressors into 8 categories, changes, positive events, unpleasant events, anticipation, sensory/personal, social/environmental, food related and ritual related. This is important information to have when you set up a relaxation program. If your child has a tantrum whenever there is an unexpected TV schedule change, then a relaxation routine can be practiced prior to looking at the TV Guide as a way of preparing for a possible change. The Stress Survey pays close attention to unusual fears and typical life stressors such as going to a doctor, having a new sibling, or moving to a new house.

Another helpful assessment tool is called the Children’s Inventory of Anger (Nelson and Finch. 2000). It makes use of a 4 point rating scale with emotional faces on each rating indicating from ‘1=I don’t care’ to ‘4=I can’t stand that!’ The tool is for children ages 6 – 16 and categorizes things that upset the child in the areas of frustrating things, physically upsetting things, peer related issues and authority issues. Because this is a child interview, the child must be able to point to the accurate face indicating how a situation makes them feel. There is a reliability check built into the inventory.

Structuring an observation for specific time periods when a person exhibits high levels of anxiety and stress (recess, standing in line, math class, church, meal time, etc.) and taking note of what seems to be upsetting to the person or what the environmental conditions are like (loud, difficult, confusing, unpredictable, etc.) can give caregivers the information necessary proactively plan a stress reducing routine.

Muscle Relaxation

Muscle relaxation is what most caregivers have in mind when they say, “just relax” to an anxious child. Such direction is easily given but few of us understand how very difficult it can be!

Joseph Cautela and June Groden wrote a relaxation manual for adults, children and for children with special needs (Cautela & Groden, 1978) that continues to be an excellent source for not only understanding muscle relaxation, but also for presenting ideas of how to teach such routines to individuals with ASD. The manual introduces the use of muscle relaxation by explaining that your muscles automatically tighten when you feel upset and by relaxing those muscles, you can help yourself feel more relaxed.

Most muscle relaxation programs begin by teaching children to identify their muscles, locate them, and practice making them feel tense and relaxed. This can be done through direct teaching and repetitive practice. Using visuals to illustrate the routine can help the student focus on one muscle group at a time.

For example, you can use a picture of a person with the top of the person’s head being #1, neck being #2, arms #3, etc. Relaxing muscles in a systematic and repetitive way will increase the student’s ability to remember the routine.

A Boy and a Bear by Lori Lite is an example of a children’s book written to assist children in practicing muscle relaxation. When My Autism Gets Too Big! by Kari Dunn Buron is example of using a book to help teach relaxation to children with ASD. In both of these books, the authors include slow rhythmic breathing as a part of a relaxation routine.