Case Study – Transitioning Between Separated Parents

Background

D was a 9-year-old boy diagnosed with autism.  At the time of referral to Middletown Centre for Autism (MCA) D attended a mainstream primary school.  His interests were watching YouTube, playing video games, swimming and doing jigsaw puzzles with his grandfather.  D was the only child of separated parents.  From a young age D lived with his mother but had frequent overnight stays in his father’s house.   There were differences in parenting styles and expectations in both homes which were challenging for D, especially at handover.  During D’s referral to the Centre, his dad’s new partner and her two young children moved into his father’s house permanently.

Triggers 

After consultation with both of D’s parents, the following triggers were identified:

Both parents reported that following the transition and handover, D would be uncooperative and emotional.  Small requests, such as packing or unpacking his bag, caused an intense response where D would get upset, shout and throw belongings on the floor and bang the furniture.

There was a long established communication system using a handover book between the two parents.  As D’s reading and comprehension developed he was able to process what was written in the book and this caused his anxiety to escalate resulting in emotional outbursts.

Adapting to the different expectations in the two homes regarding homework, amount of screen time, participating in family activities and bedtime were challenging for D.  Negotiating the two systems often resulted in D refusing to do homework, refusing to come off video games and refusing to adhere to the bedtime routine which then impacted on sleep.

Strategies

Both parents agreed to implement and use the following strategies consistently:

D’s parents could not agree on ceasing the use of the book but they did agree to keep it concise and positive.  Both parents agreed to communicate via text message before leaving home with D for the handover.

Monthly calendars were introduced in both homes so D could see when he was in his Dad’s home and when he would be in his Mum’s home.  Additionally, weekly calendars were also introduced in both homes so D could see more clearly weekly who was picking him up or leaving him to school.  Both parents agreed that they would ensure the monthly and weekly calendars were visible and that they would refer to them regularly when preparing D for the transition to the other parent.

Both parents agreed to homework lasting no longer than 30 minutes and that the minimum homework (identified by school) would be completed.  A First / Then schedule was implemented for homework. D was allowed to choose a reward if he completed additional homework.  A timer was also set.  A visual system of a green arrow indicating where homework started and a red arrow for finish point was used.  Both parents agreed that homework would be reviewed in partnership with D’s teacher once the homework routine was firmly established.

Both parents agreed to limit screen time to either two sessions of 30 minutes or  a single one-hour long session.  The alarm on an old phone was used with reminders set 10-minutes and five-minute prior to time being up.  This benefited both D and his parents.  A social narrative was created to help D understand that he could finish his game at a natural break in the game, save it and re-start at that point the next time he played.  In addition, his mum agreed to draw D’s attention to this concept when he was building large jigsaws puzzles which was one of his special interests.  Both parents agreed to no screen time after tea-time as transitioning off the game impacted negatively on D’s bedtime and on the family each evening.

The MCA co-ordinator and D devised a communication schedule that was satisfactory to all.  It involved D talking on the telephone, not a video call, just once while apart from his parent at an agreed time.  D did not like talking about school so it was agreed there would be only one question about school.  The length of the call was set at 10 minutes; D could talk for five minutes on any subject he liked, and the remaining time was general conversation.  This agreement was signed by both parents and visual reminders of the main points were created for all.  D also agreed that on the other days he would communicate via short text messages using his parent’s mobile.  Texting was a more predictable and comfortable method of communication for D.

Summary

Both parents reported that the introduction of the calendars had a very positive effect on D.  They both felt D’s anxiety was reduced as were the emotional outbursts due to the calendars providing D with clarity about who he spent time with.

Both parents implemented the First / Then schedule for homework and agreed that the visual system of green and red arrows was effective as was earning a reward of D’s choosing if he completed extra homework.

The options of two screen-time sessions of 30 minutes or  a single one-hour long session with an alarm was effective, however D was able to negotiate with one parent for additional time most days. The usual challenges persisted on these days.

Both parents reported that communicating via text message had a significantly positive impact on D.  The handover book was still in use, however D and his dad now completed it together and at times D added a drawing based on what his dad wrote in the book.  D’s mum also found this positive as it gave her something to chat to D about when he returned to her house.

Telephone communication between D and his parents was improving but still a challenge at times for D.  Both parents said the reduction of expectation and demand on D had decreased therefore this was positive.

Overall, with the MCA co-ordinator’s support, D’s parents recognised the need to liaise closely with each other to ensure D’s needs were understood and met and to ensure his anxiety was managed.