“Yes, you go to speech at 9 am on Tuesday morning,” I said again, for about the 26th time in less than 5 minutes. “Yes. And OT is Friday at 9 am?” “Yes.” This was an ongoing conversation between a student and I about her speech and OT schedule. We had this conversation every single day. For 5 months. 5. Months. As soon as she looked at me at 8:50 am every morning I was mentally prepared to have our morning discussion. Some mornings one of us wasn’t at our most patient but the other seemed to dole out extra patience in those circumstances so our dance could continue. And continue it did! I made sure to give a visual and verbal schedule to support this, but the conversation still happened. And it happened because the student was trying to make sense of the pictures in her mind and where they fit into her day. It wasn’t that she “needed” for things to be the same, but it was something that was “stuck” in her brain.
I’ve had some people ask why children with Autism will do this, are they just trying to be difficult? No. Are they not listening to, the first few times I give them an answer? No. Do they even care what my answer is? Yes. Think about perseveration like being stuck in a loop or a record that keeps skipping. The record player wants to move beyond the glitch in the record, but the needle won’t allow it. That’s what I picture it to be like, the child wants to move past that point but the trigger in their brain won’t let them. Perseveration can be brought on by a multitude of reasons;
They are trying to categorize information in their environment. They are attempting to process difficult information. It is comforting. They are trying to solidify what they are processing too long-term memory. Something in their environment is creating anxiety for them.
Sometimes there is a “picture” in a child's head that they want to store in their memory. The anxiety is around them losing this picture in their head before it can be put into memory, therefore being lost to them forever. So a child might perseverate on the same object, item, activity, etc. because if they stop the important thought won’t come back. The first step in helping someone with perseveration is figuring out it is, in fact, a problem for the child. Does this seem to stress them out? Do they couple it with other things (wringing of hands, pacing, present frustration) that is showing you they are anxious? If you ignore or abruptly cut them off will they get upset? These are the times you know they need extra support because they can’t get out of the loop on their own.
So what can we do to help our friends who are finding this challenging? Once you do a little digging and find out a little about whey the child might be doing this you are better to equip to utilize strategies such as;
If it is something that is creating anxiety try some mindfulness apps on your phone or iPad. This will give the child a visual and verbal guide through the de-escalation process. Have the child take a “break” and do some breathing techniques (such as “Pinwheel” breathing; have them hold out a finger and pretend it’s a pinwheel and blow on it. Better yet, get a real pinwheel to decrease the stress even more!).
Try some sensory breaks where you have the child do movement activities such as running, heavy lifting chores, stretching their bodies, or yoga. These types of activities will also help with self-regulation. Most children with Autism are visual thinkers. Print out a picture of an empty room, closet, or garage. Teach them that when they have those thoughts that won’t leave their brain it’s ok to write it down (or have someone do it for them) and store it in the closet (or room, or garage) and it will be there waiting for them when they, and you, have more time to talk about it. Have them get involved in fine motor activities such as digging beads or coins out of play dough or putty. Set a visual timer for the child. Set up the expectation that after that time you will be moving on to a new topic. It’s important to follow through with this expectation or else you’ve set yourself and them up for failure next time.
The more strategies we can give someone when they are perseverating on something the easier it will be for them to learn how to get out of the loop independently. By gently guiding them and showing that you don’t want them to forget their thoughts, but rather talk about it at a more appropriate time, is showing them that you respect them and what they are thinking. I hope you all have a wonderful day and Shine On!