Recommendations on how to help children with special needs to cope with war stress

In the unpredictable conditions of war, a surge in this kind of behaviour is only to be expected. Forbidding and suppressing these natural reactions to what is happening around might worsen the emotional burden. Think about how you can still let the child engage in self-stimulating activities but in a more socially acceptable way. Can you find alternative behaviors? The child may be overly active, run, scream, destroy, break everything, the child may show aggression. How can you still let your child express all these emotions, but in a more acceptable way? What are the alternatives that best fit your child?

In case of persistent auto-stimulations (hitting objects, intense movements such as swinging or extreme vocalizations, etc.) you might find it helpful to redirect children towards other sensory activities instead of trying to stop the current self-stimulating behaviors. For example, vocalizations can disappear with singing or listening to music; hitting objects is reduced when hands are busy with other sensory toys; or is there a way to find something appropriate to hit?

In order to reduce anxiety and socially unacceptable behavior, you can incorporate sensory toys and games in your routine. Can you include anything from below into your child’s activities?

• kinetic sand, ready playdough or salty dough/corn dough (can be made at home and does not contain gluten)

• any games with water (playing with objects in a pan, pouring water)

• games with grains (looking for hidden treasures in buckwheat, lentils, rice or measuring grains and pouring them from one container into another)

• any games with respiration (breath to make object move and fall from a surface)

• wrinkle and tear off paper (for example, old newspapers), throwing them into a bin

• making a tent with blankets to let a child hide himself in case of sensory overwhelming

• putting a child in a blanket/shit/towels...and make deep massage to all body parts, especially feet and legs

• listening to classical music

• taking soothing baths or showers

There might be things or activities that you might want to reduce exposure to. For example:

• exposure to excessive noise (is there a way to use earplugs?)

• some songs (are there songs that increase anxiety in your child?)

• excessive time spent on gadgets

Sensory toys and activities should give the child opportunities to explore and better understand their body and express emotions. Engaging in sensory activities and playing with sensory toys is often a normal human need in stressful situations which helps to reduce feelings of stress.

Read more about healthy diet and progressive muscle relaxation in the recommendations for adults here.

Teach children to take frequent breaks. Frequent short breaks help the body recover. Integrate 10-second breaks into any activity you are engaging in at the moment. You do not need to push yourself to succeed or achieve your goal at the expense of your body. You can practice 10-second breaks during any activity, be it teaching in a classroom, working on documents, working with a child on something together. Even if you have to focus on a very difficult task it is still important to take these very short breaks. It might help to take them together with other people since they might need a short break too. Pauses serve a structural function that adds predictability in life and therefore some stability. Otherwise you might deplete your resources and your body will force you to take a pause but in a maladaptive form (sometimes in a form of excessive distress, irritation, apathy, disease, burnout, etc.).

Pauses belong in speech too. Make pauses when you talk to other people or yourself. Sometimes our thoughts race at a speed we cannot follow or comprehend which might be stressful. Taking pauses will help you slow your thoughts down and therefore tone down and level down stress and anxieties we sometimes experience. Speaking more slowly with pauses will also make your speech easier to comprehend for your listener(s) because pauses give the sentence shape and help to bring out the main idea. Therefore teach children to make pauses in their speech. They do not need to rush when they are talking.

You probably have heard a lot about deep breathing. Deep breathing helps the body to slow down and rest from fast pacing activities. Teach a child to do a deep breath exercise. You can do it together. Here is an example on how to breathe:

1. Find a comfortable position and do body check

2. Let your breath flow through your nose and out through your mouth

3. Try to breath gently and regularly

4. Sometimes it helps to count as you breathe in and breathe out (count from 1 to 5 when you breathe in and breathe out).

You might wonder if breathing is helpful at all. Does it affect the brain? Yes: slow breathing with a longer out-breath is one of the best-studied ways to bring arousal down. It strengthens the parasympathetic, “calming” side of the nervous system — in which the vagus nerve plays the leading part — and so balances the sympathetic side, the one behind the fight-or-flight response.

Another way to take a break (pause) is to listen to music that you like and the one that does not antagonize you. Singing, humming to yourself and calm music also help many people settle. Try them and see what suits your child.

You can teach children (and yourself) the following self-helping activities after intense learning:

• Deep rest for the body

• Breathing practice during pauses

• Meditation or mindfulness practice, where possible

• Progressive muscle relaxation

For example, you can create a visual schedule. It can be drawn by hand and verbalized to your child out loud. If it is not possible to create a visual schedule, say it out loud and give prompts (physical, gestural, modeling) to help your child to execute the planned activities.

The schedule and prompts should be easy to understand and easy to follow. It matters not only to show the child the schedule but also to say it out loud.

1. Take a mug (or another object that can act as a mug)

2. Place it on a safe surface (table)

3. Take a bottle

4. Carry the bottle to the mug

5. Flip the bottle towards the mug

6. Pour water without spilling over the rim of the mug

7. Place the bottle on a safe surface

8. Close the bottle

9. Drink water

• a child puts on pajamas;

• takes dirty clothes to the dirty laundry bin;

• brushes their teeth;

• washes their face;

• goes to bed;

• hugs mom;

• listens to a story read aloud by mom.

Rituals shape habits, the daily routine and a predictable order of actions. And they soften the blow of change. Rituals give a child with ASD peace of mind because he/she knows in advance what is going to happen next and what he/she should do.

It is the predictability piece that helps people to feel that they can handle life. You do not need to turn the whole of life into a timetable, but in some places predictability helps a great deal. Constantly sizing up the surroundings and working out what to do next is a heavy load. Familiar actions give a break: they can run almost on autopilot, and the effort goes into something pleasant instead.

In a situation when you are not at home due to martial law, but in a bomb shelter or in a temporary residence, try to support the typical schedule of the child's day and their rituals as much as possible

Including your child in a daily routine (set a table, clean a table, throw out trash, load a washing machine, water flowers, etc.) can help you and your child shift attention from what is going on around you to something clear and manageable. The repetitive nature of rituals creates a sense of predictability and therefore might serve as a coping strategy with stress. Not every child is able to perform these tasks on their own. In this case the job of an adult is to provide the help (prompts) to the child to learn to perform different tasks.

Chores are also one more reason to spend time together, usefully. So, stay positive and supportive for your child. Focus on practicing 1-2 chores at a time in a structured environment and do not force your child. Try to set things up so that the steps of each chain — in an activity or a chore — are achievable and enjoyable. Provide a lot of praise and other types of positive reinforcement. Help them to feel successful and valued. Please do not include activities that your child might find aversive or do not turn chores and rituals into something aversive and therefore traumatizing for both you and your child.

For example: draw at the table, sort household items or learn new words. Be sure to include walks outside into your child’s daily activities; a trip to playgrounds (if possible) where the child can be among peers. Incorporate a few rituals into your daily routine. An example can be feeding birds outside. Before the walk, pour grains into a jar or bag together with your child, look for places where birds can be and feed them. Drink hot chocolate or juice on a bench before returning home, etc. Feel free to come up with those rituals that suit your family most. Just remember that the purpose of the rituals is to bring comfort and joy. So, try to include those activities into your rituals that promote a sense of hope, safety, comfort, and happiness.

Changing a child's activities from one to another in a stressful situation can serve as a behavioral coping strategy. Refocusing the brain from one activity to another, in this case from the traumatic situation by some pleasant activity, can help distract the child from the traumatic situation. If possible, create a space where your child can stay alone by themself if they do not want to be bothered or with you nearby. The space can be a relaxation zone with the child’s favorite toys and sensory toys for emotional discharge.

When I accepted the developmental age of my child, I lifted so many demands. My behavior mathed his developmental age. That helped to feel happy together. I allowed him to be who he is and it in turn helped him to develop and grow despite the fact the ongoing war. He finally started cooing and watching very simple cartoons for very young children. I started allowing myself to behave and respond to him as if he is very little even though he does not look like this at all. He started getting what he needed to get.

Absence of punishment for unachievable developmentally inappropriate goals, focus on play, and acknowledgement of his developmental age helped him and me to regulate his behavior and emotions better. For example, he started to put away his toys when he is done playing or giving a basket to me with toys. He started showing attachment to people. For example, he ran to greet and hug my friend he had not seen for a month and a half when she visited us. He was not used to doing that before. He started showing more positive emotions and his relationships with people improved in general. He is more interested in people now.

It was not easy to accept my son’s developmental age at all. It was not easy to lift demands from him. I had to change my whole perception of him, our communication, relationship. I needed to go back and look at the pictures when he was much younger, when his sister was much tougher to remind myself of how they used to behave and I how I used to see them. I started watching videos of children play, children who match his developmental age. I watched what they are interested in, what toys they like, how they played with them, how they and adults in the videos talked to each other, what voice intonations they used. All these helped to change my attitude towards our communication, find appropriate toys for him, my tone of voice, and meet him where he is.

When possible, try to follow these tips when working on your relationship with your child (children):

• Determine your child’s developmental age and find what is appropriate for this age.

• Don't ask your child for more than they can handle (perform).

• Simplify instructions to the child’s developmental age.

• Provide more prompts to help them feel more successful. This does not mean too many prompts, which can make a child dependent on them.

• Praise your child often for completing instructions, both independently and with help

• Do not take things that your child can perform for granted. Find space to celebrate small achievements.

• Avoid ambiguous messages. Do not speak in veiled phrases. Phrases should be clear, short and mean exactly what you are saying. If you ask to “give me a cup”, you should understand that the child will give you any cup, and not, for example, a blue one, which you might have wanted, but you did not communicate that to the child.

• Address the child only when you are sure that they are not busy with something else. Attract their attention and only then give instructions.

• Feeling happy or enjoying simple things might help as well. Sometimes I wake up in the morning and run outside, drink warm tea, hear birds singing, and look at the sun. I am glad that I am alive, my children are alive. During the war, I learned to appreciate what I have at the moment. This attitude might help to notice small good things in your child (children’s) behavior. Try to verbally acknowledge it to your child (children) or show it any other way they can understand.

Social stories might be a good accessible way to prepare your child about any changes in their daily routine. For example, if you know in a day that you will be moving from one place of residence to another, draw by hand (on a napkin, paper) in the form of a comic strip, with a short text, a plot in which you describe all the actions in stages.

Here is a sample text for a social story:

1. Mom and Sasha pack things into a suitcase.

2. Mom and Sasha carry their belongings to a car/bus.

3. Mom and Sasha get into a vehicle and go to a new house.

4. On the road, Sasha watches cartoons/plays games/looks out the window.

5. Mom and Sasha arrive at the new house.

6. Mom is very happy that Sasha arrived calmly and stayed in a good mood.

7. Mom hugs and praises Sasha.

Social stories work best when the pictures are backed up by video examples, explanations in words, frequent repetition and matching what is drawn with what is happening around. That is more effective than simply showing a picture.