It can be a struggle for children on the autism spectrum to identify their own feelings or emotions, or, in other words, to “tact their internal state.” Children on the autism spectrum may also have difficulty controlling the intensity, duration, and types of emotions they experience (coping skills). Consequently, it can be extremely helpful to teach your child strategies or coping skills to implement when they feel overwhelmed by an event or a situation, or by their own feelings or emotions. Some of these strategies include the short-term goals of asking for help, asking for ‘calm down’ time,’ and taking deep breaths.

Helping your child progress towards mastering the long-term goal of “coping skills” will help your child to learn self-management and may reduce stress caused by emotions that may be challenging to cope with. 

The following strategies may increase your child’s ability to regulate their emotions:

• Build and maintain a routine. Building and maintaining a routine for your child can be one of the best strategies to manage behaviors and emotions. Routine can provide increased comfort to children on the autism spectrum. As is age-appropriate, make a sleep and wake routine for your child, a household chores routine, a daily exercise routine, etc. Use a visual schedule to help your child keep track of their day and provide positive reinforcement via rewards or verbal praise when your child adheres to various routines. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behaviors to be supported solely by social reinforcement.
• Go for a walk or exercise. Take your child away from an overwhelming environment by walking around outside where trees and other outdoor components are expected, as this may help your child continue with the rest of their day in a better mood. Provide opportunities for your child to exercise as age appropriate, as this will release tension and decrease anxiety.
• Deep breathing. Taking deep breaths is widely known to be a useful de-escalation technique for anyone experiencing emotional overload. For children on the autism spectrum, it can be useful to practice fun “deep breath” activities when they are calm. Then, when your child is having trouble regulating emotions, you can draw on these practices in the moment. Deep breathing exercises can help to calm your child and ease anxiety, as well as help prevent your child from holding their breath or breathing too fast. Deep breathing allows for more oxygen to get to your child’s brain, allowing your child to calm down and think more clearly. For example, teach your child “belly breathing.” Have your child lie on the floor and place a small and light-weight toy on their stomach. Ask your child to breathe in slowly through the nose and feel the toy rising up. Then, direct your child to breathe out slowly through the mouth and notice the toy lowering down. Repeat three times, and provide a reward for successful completion of the breathing exercise. You can also use one of the strategies below to help your child learn deep breathing. You may choose to use positive reinforcement to encourage your child to repeat the breathing exercises: offer a piece of candy, a small toy, etc. Phase out the positive reinforcement when the skill has been sufficiently acquired. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behaviors to be supported solely by social reinforcement. Some breathing strategies are as follows: 

• -> Use “breathing beads” or “breathing fidgets.” Using a beaded fidget bracelet, ring, or other toy, have your child take a deep breath as they move each bead down the string (if using breathing beads) and gradually work through them all. If necessary, flip the breathing beads or breathing fidgets and work through the beads again.
• -> Pretend to blow out candles. Have your child pretend each of the fingers on one of their hands or on one of your hands are birthday candles and they need to blow them out one at a time. Work through them slowly and remind your child to take a deep breath in before blowing out a “candle.”
• -> Blow bubbles. While technically this isn’t a breathing exercise, blowing bubbles does require that the person take deep breaths beforehand. This can be a great way to have your child take deep breaths while focusing on something other than their escalating emotions.

• Provide access to a “calm corner” or “calm space.” It can be helpful for your child to have a designated “calm corner” or “calm space” in your home where they can go to calm down and feel more at ease. This may be a space where your child goes alone, or where you go to be with them; this preference will depend on the child. It does not need to be an entire room or an elaborate space. Anywhere your child feels safe will do, even under a table or behind a chair. Provide whatever items will make your child feel comfortable, perhaps a blanket or pillows, or calming sensory tools (depending on your child’s preferences), and allow them to practice emotional regulation.
• Offer preferred sensory activities. If your child has preferred activities that put them at ease, when they ask for “calm down” time, that can be a good time to offer those activities. These will differ based on the child. For example, children on the autism spectrum often find various types of music to have calming effects. Play different types of music for your child and figure out which one has the most calming and soothing effects on them. Provide daily opportunities for your child to listen to their favorite music, so then when they become overwhelmed, you can provide the favorite music to help your child feel more comfortable. You may use any sensory activities that your child really loves, and offer your child the opportunity to do those when there is a need to calm down. It may be helpful to have whatever you use to play the music or the activities in a place that your child can easily access or within your reach should they require it.
• Shift focus. If your child is showing signs of distress, have them try this five-step grounding technique: Start with 3 deep breaths; next, identify 3 things that they see; next, identify 2 things that they hear; next, identify 1 thing that they can smell; lastly, take 3 more deep breaths.
• Additional Resources

For the parents:

How to teach DEEP BREATHING EXERCISES to children with Autism to help them calm down... - Bing video

Autism Calming Strategies - Bing video

Teaching Coping Skills - I Love ABA!

Elegant Report - The Big Four: Developing Coping Skills (okautism.org)

The Breathing Stick | Momentous Institute - YouTube

How to make breathing beads - YouTube

For the child

Visual Mindful Breathing Mindfulness Exercise for Autism / Special Needs - Bing video

Coping Skills For Kids - Managing Feelings & Emotions For Elementary-Middle School | Self-Regulation - Bing video

A to Z of coping skills - ELSA Support . Coping Strategies (elsa-support.co.uk)

What are Coping Skills? | For Kids - Bing video

Asking For Help - Bing video

In order to help your child master the long-term goal of coping skills, you can work on the short-term goals of asking for help, asking for “calm down time,” and taking deep breaths.

Asking for Help

For the short-term goal of asking for help, you can choose a target, such as asking for help with your words, asking for help with a non-verbal cue (i.e., hand-raising), asking for help with both a non-verbal and verbal cue, identifying who to ask for help, etc.

• Step 1: Decide what method of asking for help you would like your child to learn. For example, you can choose the target of asking for help with both a non-verbal and verbal cue while working on the short-term goal of asking for help. The task analysis for asking for help could be as follows:

1. In the room you usually play, identify your favorite toy out of reach.
2. To ask for help, first raise your hand to signal that help is needed.
3. Then, ask your parent for help by using a preferred communication method to indicate that help is needed (e.g., say, “Please help me reach the toy.”).
4. Get the toy with help from your parent.
5. Thank for the help. 

• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as an image of a person reaching for something, or a verbal SD (“Time to ask for help to get your toy!” or “Let’s practice how to ask for help!”).
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt their part independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently (i.e., their part). For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, if your child is able to complete their entire part of the task analysis independently, record how long it takes your child to complete it independently (e.g., 1 min, 3 min, 5 min, etc.).
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of asking for help with both a non-verbal and verbal cue), provide the SD from Step 2 and allow your child to attempt their part independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to identify the toy out of reach, followed by asking for help with a non-verbal and verbal cue).
• Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently (i.e., their part). Alternatively, you can track progress by recording how long it takes your child to complete their part in all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at asking for help with both a non-verbal and verbal cue during a session. 
• Step 6: Track how your child makes progress to meet the target of asking for help with both a non-verbal and verbal cue by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at asking for help with both a non-verbal and verbal cue over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete their part in all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Asking for 'Calm Down' Time

For the short-term goal of asking for ‘calm down’ time, you can work on the targets of asking for ‘calm down’ time after 5 minutes of an activity, asking for ‘calm down’ time with a non-verbal cue, asking for ‘calm down’ time with a verbal cue, etc.

• Step 1: Decide what method of asking for ‘calm down’ time you would like your child to learn. For example, you can choose the target of asking for ‘calm down’ time after 5 minutes of an activity while working on the short-term goal of asking for ‘calm down’ time. The task analysis for asking for ‘calm down’ time after 5 minutes of an activity could be as follows:

1. Sit in a chair at a table having a coloring activity (e.g., paper and crayons).
2. Set a timer for 5 minutes. 
3. Start coloring.
4. Do the activity until the timer goes off.
5. When the timer goes off, ask for ‘calm down’ time.
6. When the ‘calm down’ time is granted, stop coloring and have your ‘calm down’ time.

• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as an image of a child meditating, or a verbal SD (“Time to ask for ‘calm down’ time after 5 minutes!” or “Let’s do an activity for 5 minutes then ask for ‘calm down’ time!”).
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the task analysis independently, record how long it takes your child to complete it independently (e.g., 7 min, 10 min, 15 min, etc.).
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of asking for ‘calm down’ time after 5 minutes of an activity), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to start a 5 min timer, then color until the timer goes off, followed by for ‘calm down’ time).
• Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at asking for ‘calm down’ time after 5 minutes of an activity during a session. 
• Step 6: Track how your child makes progress to meet the target of asking for ‘calm down’ time after 5 minutes of an activity by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at asking for ‘calm down’ time after 5 minutes of an activity over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.

Taking Deep Breaths

For the short-term goal of taking deep breaths, you can choose a target, such as 5 finger breathing, taking 5 deep belly breaths, balloon belly breathing for 3 minutes, etc.

• Step 1: Decide what method of taking deep breaths you would like your child to learn. For example, you can choose the target of taking 5 deep belly breaths while working on the short-term goal of taking deep breaths. The task analysis for taking 5 deep belly breaths could be as follows:

1. Lay a towel or yoga mat on the floor.
2. Get a favorite light-weigth stuffed animal.
3. Lay on the towel or mat with your belly facing up.
4. Place the stuffed animal on your belly.
5. Slowly take in a deep breath so that your lungs and belly fill with air.
6. Watch as the stuffed animal on your belly rises.
7. When your chest and belly are full of air, count to 3.
8. After you count to 3, slowly breathe out and watch the stuffed animal as it lowers. You’ve completed one deep belly breath.
9. Repeat the previous steps so that you complete 4 more deep belly breaths.

• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as an image of a person breathing out, or a verbal SD (“Time to take a deep belly breaths!” or “Let’s breathe deeply!”).
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently. The baseline level will vary according to your child and their specific abilities. Take data on which steps were accurately done independently. For example, you can count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, if your child is able to complete the entire task analysis independently, record how long it takes your child to complete it independently (e.g., 3 min, 5 min, etc.).
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of taking 5 deep belly breaths), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, employ a model prompt to show your child what to do at the beginning of the following trial (e.g., model for your child how to lay down and place the stuffed animal on your stomach, then breathe in deeply such that the stuffed animal rises on your belly, followed by breathing out deeply).
• Step 5: Collect data on how your child makes progress. For example, count how many steps in a row (from the task analysis in Step 1) your child can complete independently. Alternatively, you can track progress by recording how long it takes your child to complete all the steps from the task analysis in Step 1. Or, alternatively, you can track progress by counting the number of successful attempts at taking 5 deep belly breaths during a session. 
• Step 6: Track how your child makes progress to meet the target of taking 5 deep belly breaths by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at taking 5 deep belly breaths over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can complete all the steps from the task analysis in Step 1, and compare that with the percentage threshold necessary to meet the target.