Having a vaccination generates anxiety in most people. However if the purpose of a Covid-19 Vaccination is understood, people will endure momentary discomfort in order to benefit from the health benefits the vaccine brings.
Armed with this knowledge people visit a vaccination centre, which may be a hospital or GP hub. It may also be a football stadium, church or other venue which has been adapted for the purpose.
There they are guided through a process by helpful staff who wear tabards or lanyards identifying them as people who can help. In the vaccination area there are visual clues such as a chair, a table with medical items and a nurse wearing PPE, which guide people to where to sit and who to expect will be doing the vaccination.
Typical people recognise the context of each part of the vaccination procedure. This context guides them to pay attention only to the social factors described above that are relevant to the context, ignoring all other irrelevant factors.
This relieves anxiety and leads to the choice of a safe and effective social response. For typical people who are inherently context sensitive this happens for them without any conscious thought.
For an autistic person with context blindness, this may not happen for them. Without the information that comes from reading context the situation may be profoundly frightening. Not knowing what will happen next, how long it will take, when will it finish, and why it is a good idea can cause extreme anxiety.
A Social Story about vaccination will describe the purpose and the procedure and bring together all those relevant cues that may be missing for an autistic child or adult. I am attaching an example below. It will not match the child or adult you are supporting and must be adapted to the individual concerned. Their perspective must be paramount.
The Story needs to be exactly at their level of understanding and should follow the 10 criteria that are so important in writing a safe and reassuring Story. Factors that might cause an individual anxiety or distress need to be considered, explained and as much as possible any reassuring ‘props’ accommodated and included within the Story eg noise sensitivity and the use of headphones.
Any comfortable way of counting out three seconds of time will give a clear indication of when the pain will finish (I have used the idea of counting to three penguins for this person). It is important to include the idea that there may be delays, and that when the Covid-19 Vaccination is done there is additional waiting time.
I have also included a page related to the understanding that this is the first of two vaccinations to avoid confusion when recalled. Having a Story like this illustrated with photos from the actual vaccination centre is ideal, and of course will help recall what happens when the person has to return the second time.
As a population we are all feeling anxious as we cope with continual uncertainty. We are in fact experiencing a taste of life on the autism spectrum, where uncertainty and unpredictability rules the day, with all information vague and ambiguous. The two things neurotypical people now crave, just like our autistic population, are accurate information and certainty of outcome, two things which are in short supply. One benefit of the pandemic may be a deeper awareness of how it may feel to experience life on the autism spectrum!
We are in fact experiencing a taste of life on the autism spectrum, where uncertainty and unpredictability rules the day, with all information vague and ambiguous.
As we begin to prepare for a cautious and stepped return to another kind of normal life, we need to prepare our autistic children and adults for another change. This is problematic in itself because so little in our life is currently certain, every future step dependent on the subsequent response. Our young people crave predictability and certainty and in this fluid situation we are unable to give them exact dates and times.
Social Stories provide social information that inform and reassure, filling the gaps left by a different interpretation of the world. A Social Story can therefore reassure that although timings remain undefined, there is certainty that we, their loved ones or carers, will deliver information in good time before any change happens for them. This is important for them to know and important for us to do.
Return to school
It seems likely that a phased return to school will happen soon. There will be a lot of change to become familiar with. For our children all of these changes will need to be explained and described with concrete visual information and Social Stories, preferably before returning to school.
(A chapter on transition Social Stories, with an example of a school transition Social Story, is included in my book, ‘Successful Social Stories for School and College Students’.)
It is not all negative however. Lockdown has brought positive change too. Many of our families have discovered that the slower pace of a life lived more simply, with reduced social expectations has been a relief. As we return to school some positives may continue for our children. Instead of returning from the quiet sanctuary of home after a holiday break to a full classroom and assembly hall, they will be returning to a quieter, less social atmosphere, and importantly not to a full week’s timetable.
Children who found the proximity of other children in busy school corridors, noisy classrooms, crowded assemblies and playtimes may actually find social distancing much more comfortable. Once one-way systems in school corridors are understood, our children may prefer the reduced noise and likelihood of others bumping into them.
many of the changes the population will have to embrace in the future may make school and workplace more autism friendly, as well as safer for all!
During this time people have had to change their way of greeting others and it has become normal not to shake hands, or kiss both cheeks in the continental way, but instead just nod, smile or say hello. As we face a new normal and the potential return of Covid-19 in the future these greetings will continue to be recommended for safety. How helpful that they have always been more comfortable for our young people. It seems to me that many of the changes the population will have to embrace in the future may make school and workplace more autism friendly, as well as safer for all!
Visual Timetables
Once you have more information from school about your child’s return, make sure they know what days they will be in school and what days they will be at home on a visual timetable displayed at home. This can be very reassuring. On return to school, take a photo of the entrance and exit they will be using, and place these on the calendar along with the time they will be entering and leaving school each day. Knowing that there is an end to an experience is crucial information to those who have difficulty making predictions. These times are likely to be different to normal, and building familiarity as quickly as possible with the new routine will be helpful.
Always put on the timetable anything you can find out that will be the same as before. If you cannot find out much, don’t panic, you know your child will have, for example, their lunchbox with their usual food in, and maybe a snack too that they know and like. A photo of this can be placed on a timetable and be a positive, familiar anchor point in the structure of the day. The child will begin the day at home with a familiar breakfast activity then return home and do another familiar activity at the end of the day and a photo of these two activities can ‘frame’ the start and end to the day on the visual timetable.
Remember that some of the activities that were hard for your child before may not be happening. So it’s important that they know that Assembly, or Games, or P.E. may not happen. This may be reassuringly good news!
School is unlikely to be able to give details of everything your child will be doing, but they will be able to say who the child can turn to for information at school. Their usual LSA, who would know when to tell them of change, may not be available with the resourcing changes. If this is the case, telling the child who knows what is happening helps them know who to ask, and practicing the question at home, ‘Whats next?’ enables them to do this.
Understanding the words people are using
Many of us are now familiar with the new vocabulary that has emerged during the pandemic. It is important that our children understand these new words. Without understanding the context, they may assume a different meaning that may be quite inaccurate, and even more frightening than the reality. On return to school it is likely they will hear more of these words and therefore it is sensible for parents to ensure their child has a good understanding, explained in a positive reassuring way.
It is always a good idea to ask the child what they think the word means first, to uncover their perspective, before sharing your understanding of the word with them. Use Social Stories to do so if possible, adapting them for your unique child. Notice that in each Social Story included below I always try to mention that most people recover quickly from the virus and only a few have to go to hospital. It is easy to forget to emphasise this, but putting the situation into perspective is really essential.
Practicing at home.
Understanding the reason behind social distancing is crucial if it is to be adhered to, so once understood, model a safe social distance in a way that is meaningful for your child in a fun way.
For example, for a child interested in snakes identifying what snake would be 2m long could be his instantly recallable ‘long-snake’ social distance.
For a child that loves his bed, perhaps the distance from the head of the bed, where teddy sits, to the foot of the bed where giraffe sits. This distance can then be labelled with a name the child decides eg ‘teddy-giraffe distance’.
Use favourite toys eg teddy bear and place it on a marked spot and place another 2 metres away and have the teddies have a safety ‘lesson’ with the child as teacher.
Mark the sitting room floor or garden with cushions on the floor, 2m apart and practice sitting on them to read a story or watch TV.
The idea is to make social distancing another part of fun normal life and not scary!
Modelling and reinforcing the handwashing technique is crucial. Use the cocoa powder technique I first described in the earlier blog to refresh how well your child is currently doing in washing hands. Children are always touching their faces, and it will be almost impossible to stop them doing so, so effective handwashing really is important, and is a good habit to establish for a healthy life! Reward them when they remember to do it, and praise any improvement in technique. The more we all learn and practice this, the more automatic it will become. Effective handwashing can prevent a virus on the hands from entering the body and causing infection. This is so important as we all return to touch and use surfaces that have been touched by others.
One-way systems may be in place on return to school where previously there were two-way systems eg in corridors. Make sure they understand the term and demonstrate to your child using lego figures or toy cars how this works, or use figures from their special interest. If you have a garden, start up a one-way system, with home-made signs and move around it.
Face masks and visors may be more in evidence at school. These may be very scary to children on the autism spectrum. Describe what the term face mask means using a Social Story (link) It is important for them to be reassured the person is the same underneath when the face mask comes off. Showing how a visor made from a piece of see through plastic works and that you are still the same underneath may help. Play with other masks for fun in dressing up as favourite characters, just to make the idea less scary. Teddy or a favourite toy could wear a home-made mask or visor too?
By making what is unfamiliar familiar we can dispel fear and inaccurate assumptions. There is a great deal that parents can do to help their own children in the transition back to school, whenever it occurs, and preparation can start now.
I plan to use this space to post news of upcoming events and also from time to time to share ideas or Social Stories™ that I believe may be helpful……
Now that the new school year is well under way I am being asked once again to write Social Stories™ for children on the autism spectrum around the topic of school breaktime (called ‘recess’ in the U.S.) specifically to help them join in games and to ‘be social’ and ‘make friends’.
Break time is often one of the most challenging and uncomfortable periods of the day for our children.
Break time is often one of the most challenging and uncomfortable periods of the day for our children.It is easy to guess why this might be. Autistic children have a different sensory and social experience to typical children. They may become quickly overwhelmed by noise, the proximity of other children, the chaotic atmosphere of the playground – by all the things that make breaktime so interesting and exciting for their typical peers.
There is a problem here, and it is not with the children on the autism spectrum, but more with typical people expecting, and wanting to see the development of social behavior in all children at break time.
I believe it is important for everyone to take a step back here and think about the purpose of breaktime. After sitting still and following directions all morning children need to let off steam and ‘reset’ at breaktime in order to be able to return to the classroom refreshed and ready to learn again. Many typical children enjoy the freedom of breaktime to be noisy, running and shouting with their friends, playing games, and sometimes chatting within a group.
the needs of children on the autism spectrum are likely to be different to their typical peers. Solitude and silence are often sought out to recover from the confusing social demands of a busy classroom
However, the needs of children on the autism spectrum are likely to be different to their typical peers. Solitude and silence are often sought out to recover from the confusing social demands of a busy classroom. Pacing up and down the perimeter fence may bring comforting predictable proprioceptive input. Looking at subjects connected to their special interest in quiet areas such as the library may take the child to a comfortable and familiar place in their mind outside of the uncomfortable school experience. They may shy away from games they find difficult to understand, or interactions that they find continually baffling. It is important to affirm that it is okay to choose these activities at breaktime, and also to provide access to autism friendly environments in which to do them. Everyone has different ways of winding down and resetting.
Providing social information proactively before sending the child into the playground really does level the playing field for them and this is where Social Stories™ can really help. For this reason in the book ‘Successful Social Stories for School Students with Autism’ I have included a section devoted to Breaktime.These Stories are examples that describe the unseen, unwritten social information that guides children to more successful play with others. The first Story, ‘What Happens at Breaktime?’is a helpful reminder to child and staff of the purpose of breaktime as well as an affirmation that it is okay to choose activities that help. It is included below. Other titles in this section of the book include,
Who is the owner of a game in the playground?
How to join a game in the playground.
What is a chasing game?
What does home mean in a game?
What does the whistle mean in the playground?
What is lining up?
Who is in charge of the playground?
What happens at break time?
– A Social Story™ taken from ‘Successful Social Stories for School and College Students with Autism’ by Dr. Siobhan Timmins, published by Jessica Kingsley Publishers
At school children usually work hard in lessons. At break time children usually stop work and relax. Break time mostly happens outside in the playground. Sometimes when it is raining break time happens indoors in the hall.
Relaxing at break time usually helps children get ready for the next lessons. Some children like to run to relax. This is okay.
Some children like to play a game to relax. This is okay.
Some children like to talk to other children to relax. This is okay.
Some children like to be on their own in a quiet place to relax. This is okay too.
At break time: I may join a game or I may talk to another child or I may run around or I may be on my own in a quiet place or maybe do something else.
Usually the junior library is a quiet place to go at break time. Relaxing at break time usually helps me get ready for the next lessons. I am learning what happens at break time.
Watch this space for the next post on the more adult form of Social Stories™– ‘Social Articles’
Dr Siobhan Timmins has been writing Social Stories™ for 25 years and is a published author. She has more than a decade of experience in teaching social understanding in autism to parents and professionals, delivering workshops in Social Stories™ nationally and internationally.
Our website uses cookies to improve your experience. It would be great if you'd be ok with this, but you can opt-out if you wish. Cookie settingsACCEPT
Privacy & Cookies Policy
Privacy Overview
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
By 
