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Control, Rigidity, & Insistence on Same, Part 2

November 6, 2019 by Shannon Eidman

Insistence on same or behaviorual rigidity might include things like difficulty coping with changes in routines, things out of place, or in general things not being just the way they ‘need’ to be. The reality is that this is a very complex issue, but we hope to offer just a few insights here about how we might support individuals who struggle in this area.

First, we need to remember again that we’re focusing here on those individuals who’s insistence on same causes extreme distress. Generally, these are the children where rigidity is noticed in many different areas. This is not just a child who gets upset when you try to skip story at bedtime because it’s too late. These children are probably also quite food selective, or maybe had difficulty with toilet training and transitioning from nappy to toilet. And they might have certain activities they do with one parent and a different set with the other. In particular, the response to the change in routine or triggers are intense and seemingly inconsolable.

So, one thing to consider is the role of structure and routines. Routines can be your best friend and worse enemy all at the same time. This is where visual supports and daily schedules can be extremely helpful when arranged to promote flexibility.  Too often, daily schedules are put up on the wall and although used, may not change much from day to day. For these children however, it is important to stir things up sometimes, even if you wouldn’t need to. Periodically change the order of events, or availability of certain activities, and do so from the time the support is introduced.

Why you might ask?  Following the visual schedule itself should be the support or routine. The schedule provides important information about the day ahead. That information may change from day-to-day, but the comfort or trust should be that they can rely on and stick to that schedule.

If however we encounter a situation where the schedule or routine has been well established and the child is becoming distressed with any change, it is important to programme brief, periodic, positive changes or interruptions to the schedule.  Rather than ‘oops, you can’t go outside because it’s raining,’ you will want change or interruption of status quo to be more often associated with positive things such as ‘oops, I think we’ll watch this favourite video before we start homework.’ And it is useful to use some sort of visual ‘oops,’ ‘surprise,’ or ‘change’ icon or card. Once the icon or card is no longer met with resistance, you can begin to gradually insert less preferred interruptions.

So now on to another tip around encouraging flexibility. Flexibility is a behaviour or skill that can be learned just like any other, but it must be practiced. Once we can identify some of the specific triggers or situations associated, we can set up situations to ever so slightly challenge a child to practice flexibility and cope with disappointment. But it is critical that the challenge be small, and child taught appropriate ways to cope.

It’s probably easiest to share an example of how we approached this insistence on same with a pre-schooler. He struggled with flexibility around how toys were played with, and whom he sat/stood next to, among other things. The following chart outlines the steps we followed to get him from screaming and crying when someone interfered with his agenda, to him tolerating some change. Notice the only requirement initially is for the child to learn to request rather than scream and cry.

And why do we feel this insistence is important to address? It’s for happier children? Our own clinical observations, as well as research suggests that behavioural rigidity can result in significant distress to an individual. Peters-Scheffer at al. (2013) offer evidence that increased behavioural flexibility is linked to fewer emotional and behavioural problems, and lower parental stress levels.  

Uncategorized autism,  change,  control,  routines

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To any of our BCBA friends, if you're looking for a unique and insightful CEU, this is for you. Dr. Sarah Cassidy will be talking about her approach to supporting emotion regulation and mental health in children and adolescents. This is a great opportunity to learn more about the applications of ACT and RFT to promoting positive mental health.
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To any of our BCBA friends, if youre looking for a unique and insightful CEU, this is for you.  Dr. Sarah Cassidy will be talking about her approach to supporting emotion regulation and mental health in children and adolescents. This is a great opportunity to learn more about the applications of ACT and RFT to promoting positive mental health. 
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