Separation Anxiety in Children with Autism

This lesson is about managing separation anxiety through a programme called “I’ll Be Back”. 

 

When we tell our children, “I’ll be back”, what do we actually mean? How will our children know how long they would have to wait anxiously before we come back to them?

 

To a child on the spectrum, as well as many young children, a parent leaving the room or separating from them can be very difficult.

 

Children may be wondering, “When are they coming back?”, or even, “Are they coming back?” And this can be very stressful for them. 

 

In this lesson, we want to teach children to be able to tolerate their parents or carer leaving them for very short durations of time, gradually increasing the time. 

“I’ll Be Back” Concept

Adult says to the child, “I’ll be back!”, then the adult would leave the room and initially a timer is used to indicate when the adult would come back. The minute the timer beeps, the adult comes back into the room and says “I’m BACK!” preferably with a big reinforcer. 

Prerequisites:

  • Basic cooperation & compliance with First Then instructions
  • Understanding of the visuals
  • Ability to wait 

Materials:

  1. “I’ll be back” social story 
  2. Timer
  3. Video model
  4. First Then board
  5. Rewards!
  6. Fun activities that child can engage independently while waiting 

Before starting the programme

It’s important to assess your child’s separation anxiety from everyone at home, and identify who they are most anxious to be separated from. 

 

Then, check how long they can wait patiently before starting to look for the main person. This is critical to help with breaking down the programme targets and expectations. 

Steps:

Item List for I’ll be Back

 

1. Communicate expectations: read the social story, then watch a video model 

 

 

2. Probe: Modelling

a. Choose someone that your child does not have any separation anxiety to (e.g. teacher, therapist)

b. Demonstrate the flow by getting the person to say “I’ll be back”, set the timer and leave the room

c. Start with a short duration (5-10 seconds)

d. When the timer beeps, the person would come back with the reinforcement, stating, “I’m back!” 

  • If the child is very young and still learning how to focus and attend, he/she may not notice that the other adults have left the room 

 

 

3. Practice: preferably with adult that child will be least upset to leave 

a. Start with very short durations on the timer. 

b. Every exit comes with the instruction “I’ll be back” and every return comes with “I’m back”

c. To ensure your child’s safety, ensure someone else is in the room with your child. Ensure your child can’t see you and you have actually “left” the room.

d. When the timer goes off, immediately return to your child and say “I’m back!” while presenting the reward.

e. Gradually increase the duration that you are out of your child’s sight. You can build up the duration by 30 seconds, then increase by minutes, then by 5 minutes.

f. When it’s more than a couple of minutes, it is best to give your child a toy or activity to occupy themselves while waiting for you to return. 

 

 

4. The BIG DAY: when your child is dropped off at their therapy centre, school or daycare. 

a. Remember to follow the same steps of Communicating Expectations, more specifically with a visual on their schedule indicating that you will be back at the end of the day, using the term “I’ll be back” (the child should be occupied sufficiently while their parents are away)

b. Upon returning, give your child a big reward while saying “I’m back!” 

 

 

5. Review and Generalisation: If the practices have been going well, you can move on to generalisation 

a. Repeat Step 3’s breakdown and plan, but with different people and in different places.

b. If you need to leave for work, or drop them off at play school–use the visual. Communicate when you will return on the visual schedule, say “I’ll be back” while pointing at the visual schedule, and repeat what will occur first before you are back home. 

I’ll Be Back Routine

  1. Read the “I’ll be back” social story, show a First Then card, saying “First I’ll Be Back, (child) waits, then “reward”.
  2. Show the video model.
  3. Say the instruction, “I’ll be back”. Then leave the room and start the timer
  4. When the timer goes off, return to the room and say, “I’m back!”. Present the reward immediately. 

Your Turn

Is separating from your child difficult? 

 

If so, how could you implement this successfully? What reward would you use, how short a time would you start and who would you start practising with?

 

Go ahead, brainstorm and practice this skill!

 

Begin teaching!