Curbing Anxiety Using Social Stories, Cues, and Pictures

Question:
Does anyone use social stories with their kiddos to prepare them for events and new situations?  Often times, new situations and the unexpected will cause anxiety and lead to behavior problems.  What are some ideas that might help our children process their anxiety.

Answers:
In most cases, our children crave routine and want to know what is happening next.  If something is different than what they expect, it may lead to a meltdown.  One way to help our children process their anxiety is through schedules or picture charts. 

Idea 1:
Families have used the Picture Exchange System (PECS) mostly to assist in the language but several parents have used them for curbing anxiety.  A school or therapist should be able to assist and print out pictures for you.  There is a program with thousands of pictures to select from in order to find something that is just right.  It is best to laminate them because they will gets lots of use.  There are Velcro books and short pads (which looks like a ruler) that allow each card to be displayed and in front of the child.  

You are also able to use the cards to make a daily (kid friendly) calendar for your child to view.  You can also take actual photos for them (to use like the PECS cards) and writing the single word below.  Example:  take a photo of school,  then label it school so they also begin to learn the word.

Idea 2:

Parents also rely on a check list format when their child is going to have a new experience.  It can work like a chore sheet.  The list could contain a picture reference on the left (with some words to remind the parent of what that step really was) and then a blank box to the right for the child to check off as it is completed.  At the end, there could be a treat like ice cream or play in the park.  Parents have used this for activities like the dentist, therapy, homework, or even for something simple like brushing teeth or getting ready for school or bed.  

For example, the list could include things like:
--sit in cool chair
--put on bib to protect clothes
--let them count teeth with mirror
--polish
--floss
--get picture taken
--done!

One parent mentioned they would always at least attempt each step and the child would get a star/smiley face for those attempts. For two visits, maybe they only got the polish brush out and the child touched it with their finger. The child would still get a star for whatever they could do in that step.  At the next visit, maybe they would only get four teeth done but couldn't sit for the rest; floss maybe 1-2 places; etc.  At the child's last 2-3 visits, they were able to complete all of it and the checklist stayed at home.  The child still had anxiety, but the checklist really helped them know what was next.  This process began when the child was 3-4 years of age.  

A parent also bought a magnetic chore board and made it into a magnetic schedule at home.  The family would talk about the next day and where the child would go and what they would do. Sometimes the parent would find them huddled in a corner studying their schedule in order to process their anxiety.  The child would also prompt the parent to check their schedule. This worked well from 3 years on because the child's preschool had a similar picture schedule in place.  The family made individualized magnets (from the computer and cheap round magnets with adhesive backs); The pictures were also laminated for repeat use. 

Idea 3:

Our children are very visual people.  Below is a good site that you can "copy"" and paste the pictures.  They have pictures for morning routines, school, etc.  You can also search on the Internet for "morning routine" or something similar for the pictures you need. 

Some therapists put Velcro on a piece of cardboard and then create different pictures to show the types of activities they will work on in a day.  The child can then take them off one by one when they finish.  Individual pictures are great in case something changes in the routine.  It provides a way to process the change before the event actually happens - which will hopefully lessen or eliminate a meltdown. 

Try this site if you need pictures:   

http://www.setbc.org/pictureset/