"My daughter is 4 years old and was recently diagnosed with PDD-NOS. Recently,
she has become very uncomfortable in certain situations, when we are out in public.
I think this may be happening more now, because she understands more, as she grows
and gets older. It usually happens in a new place where she has never been. She
begins to clench her jaw and her heart races. Sometimes, she will also hold onto
herself in her crotch area. I usually talk to her and try to calm her. Since that
does not work, I will end up leaving the place. I guess I am more worried when
this happens at school when I am not there, and the staff is unable to calm her
down. My daughter has a paraprofessional with her most of the day, but it appears
that the only thing that works is to remove her from the situation. Are there
ways to calm her down, besides removing her from the situation? What is the best
thing to do, when this happens?" Ann Answer: Dr. Pam DiLavore, Lead Psychoeducational Therapist, Raleigh TEACCH Center Children with autism spectrum disorders often become uncomfortable in unfamiliar or unexpected situations. One of the best ways to help your child through these anxious times is to prepare well in advance. Many children do well with a visual schedule that uses objects, pictures or written words to show them what is going to happen. Since your daughter is a preschooler, you would probably want to make a picture schedule for her. (Even if she can already read, she may not truly understand new words until after she experiences the situation.) Make sure the picture schedule is clear and easy to understand. In order for her to learn how the schedule works, use it during her familiar, daily routine. Then when a new experience comes along, you can insert a new picture into her schedule. For example, her typical preschool schedule might have pictures showing 1) books, 2) blocks, 3) snack, 4) music group, 5) go home. On the day of a firefighter visit, you could change the schedule to show 1) books, 2) blocks, 3) snack, 4) fireman, 5) firetruck, 6) go home. Your child may still be a little anxious in new situations, but you will have given her a way to know what is going to happen (see the firetruck) and what will happen next (go home). The Do2learn web site has information about creating schedules as well as pictures that you can use to develop schedules. Another strategy that may be helpful is to teach your child simple relaxation techniques such as deep breathing or stretching and relaxing her muscles. It will be important for her to learn and practice these strategies during non-stressful times. Then when you (or her teacher) see her showing signs of anxiety, you can help her relax using the familiar techniques. Don't expect her to be able to learn relaxation strategies for the first time when she is under stress.
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