Tool Box: Social Stories

Everyone who has experienced parenting a toddler knows about their adherence to routines.  You change one little thing and the shrieks reverberate, "NO! NO! NO!"  It's supposed to be the way it was before.  Well, kids with autism tend to keep that adherence to routine much longer.  The concretes are much more part of their world.  For example, I'll never forget when my husband was painting something in the garage and I needed to park in the driveway for a few days.  Every day, for a full week, I dealt with a half hour of ballistic crying when I returned home with my son.  The car belonged in the garage.  It was in the nature of the universe for him (part of the metaphysically given http://aynrandlexicon.com/lexicon/metaphysical_vs_man-made.html ).  This was as traumatizing as it would be for us waking up to find a leopard print sky, almost any concrete (including the car's location) was part of the essential stability of his world.

Hmmm, what to do?  How about pre-setting a routine?  Enter "social stories", one of my most useful tools in my parenting tool box.  There are a huge variety of social stories based on the individual needs of the child, but I found this summary of the essentials:

"What are Social Stories?

Social Stories are a tool for teaching social skills to children with autism and related disabilities. Social stories provide an individual with accurate information about those situations that he may find difficult or confusing. The situation is described in detail and focus is given to a few key points: the important social cues, the events and reactions the individual might expect to occur in the situation, the actions and reactions that might be expected of him, and why. The goal of the story is to increase the individual’s understanding of, make him more comfortable in, and possibly suggest some appropriate responses for the situation in question. "

(http://www.polyxo.com/socialstories/introduction.html)

I know autistic kids aren't the only ones who deal with exasperatingly admirably persistent traits. Even those children who aren't officially "slow to adapt" can find more ease and comfort when they get a heads up on what's coming.  This is an awesome tool to make parenting life easier!  My best success has been with my dentist social story, so I'll review that one here with bracketed comments and a few of the pictures:

So, we start with a basic title: How Cameron Goes to the Dentist

[Pictures of the sign, the front door - setting the visual memory of what he'll see]

"Cameron has teeth."

[Naturally, we need to start with the kid's context.  A nice happy picture is good here... gotta see those teeth :)]

"We try to keep Cameron's teeth clean at home, but sometimes we need to go to the dentist to get them very clean.  This is Cameron's dentist's office." [Pictures of waiting room and front desk]

"After we get to the dentist's office, we go into a cleaning room."

[Picture of room with hygienist, looking for that rich setting of concretes.]

"Cameron sits in Mommy's lap in a special chair."

[More setting the scene, familiarizing with the context - another happy picture is good.]

"A dental hygienist gets teeth very clean.  Amy is Cameron's dental hygienist.  She uses a special toothbrush to get teeth clean."

[Pictures of Amy and the tooth brush]

"Dentists take care of teeth.  Dr. Walker is Cameron's dentist.  After Amy gets Cameron's teeth clean, Dr. Walker looks at them to make sure they are healthy.  Cameron needs to open his mouth very wide!"

[Picture of the dentist]

"Cameron gets a special toy after Dr. Walker looks at his teeth."

[Picture of toy box]

Voila!  We read the book over and over.  We point to the pictures and talk about his teeth, what happens in each place and in what order.  I answer any questions he brings up during the reading.  Finally, the pre-set routine allows comfort, smiles, and a much more pleasant experience for all concerned.

Taking my son into the dentist changed drastically.  Previously, we'd talked about it and reviewed the plans and he'd made it to the cleaning room and had maybe two teeth cleaned  before all the new input of the situation was too much and he'd start crying with distress.  (That was three visits spaced over a year.)  After the social story, we walked in and he was all grins checking off the boxes in his mind.  We arrived and he pointed out the signs and the door, just like in his story.  We walked in and the waiting room / front desk were already familiar.  His hygienist came out and he knew: who she was, where we were going, and that his only job was to keep his mouth open.

With a digital camera, a half hour at the computer, and plenty of the normal parent-child reading time, these stories have been powerful tools.  On a side note, they were an absolute hit in his pre-school classroom as his classmates loved the series too!  His classmates learned how Cameron goes to the doctor, makes popcorn, practices karate, and learns swimming.  I haven't needed as many social stories in Kindergarden (moving on to social contracts since his context has expanded - a different post to come), but I just wrote a social story today about going out to recess.  That will be a new skill for him since he hasn't mastered controlling his body around other children in active situations.  We've laid the ground work for him to understand the cognitive issues (body language, rules for personal space / games, etc.) and now it's all about practice.  The social story lets him practice in his mind beforehand and gain comfort with the setting and concretes involved.

Any time a young child is dealing with a new situation that could be challenging, this is a potentially useful tool to keep in mind.  Certainly, we can't visit every place before hand, take pictures, and teach our children what to expect, nor would we want to deprive them of the opportunity to learn how to adapt to the unexpected.  We can help the young child grow in their comfort with different situations though and thus nurture their development toward handling those situations on their own.

If you're having a challenging situation where a social story might help or you have tried this, I'd love to hear about it in the comments.  My goal is both to share knowledge and gain from the parenting experience of others.