Coping With The Holidays

Anyone who treats patients who are autistic will tell you know how stressful the holiday season can become. Expectations are frequently dashed, making the ensuing drama even more poignant. Beloved family members don’t seem to understand, making even familiar conversations more stressful.

There are numerous reasons from many perspectives that add up to make things so stressful. Schedules are thrown out the window. Spectrum patients like schedules; it helps them organize a disorganized world. Compounding this are the sensory issues that affect so many children.

Bright lights. Blinking. Stims anyone? Very loud unusual sounds and too many noisy strangers in stores. Tantrums anybody? New and often-forbidden foods everywhere. Did someone say “yeast”?

Travelling vacations can even be more anxiety producing. As Karen Vossen, our office manager put it, “Disney is no place to take some of the children – especially during the holidays!” So many strangers, odors, and stimuli that challenge the most sanguine adult assault the children who are supposed to be having fun! What about traveling to the relatives’ house? Sleep couldn’t possibly get disturbed when the child is put into a crowded bedroom rife with allergens and unimaginable unfamiliar stimuli.

So, what is the prescription for a more successful school holiday? First thing – planning. Think about what issues your child has which are particularly stressful and most likely to lead to disruptive or aversive behaviors. If your plans are going to affect those “itchy” behaviors, you need to either make other plans or prepare the child adequately. If that answer seems too “pat”, you haven’t experienced a really bad vacation yet. Children who have visual or auditory issues will definitely have problems at the airport. If they have a preferred activity such as dvd or iphone that will keep them busy, you might need to give up the ABA’s proscription against “giving in”. Social stories about the trip have been found to be helpful. Be especially sensitive to the child’s anxiety and attempt to avoid long waits (doctor’s note) whenever possible. Sometimes a little Benadryl can go a long way by making the child drowsy enough to sleep off some of the time.  Also, consider carrying an extra dose of any calming supplements such as pycnogenol or htp . Melatonin given at the incorrect time may actually make things worse by resetting the child’s biologic clock. Finally, any “juicing” medications such as B12 might be delayed or even discontinued while travelling or in especially stimulating times.

Your planning should assess what activities your family anticipates and whether an affected child will really enjoy and understand what is happening. If a particular child likes to stay with grandma, it might be OK if the child has special time with a preferred caretaker.

If your child is not feeling well, consider postponing the trip to another time. Refundable tickets and trip insurance aren’t a bad idea if you can afford the extra cost. Document all of the child’s medicines and supplements and put them in your carry-on to avoid carnage should baggage be lost or delayed. Bring a doctor’s note if some of the medicines might be considered “dangerous” or otherwise cause difficulty with the TSA. This is especially true if you are travelling outside the country.

During trips, child supervision needs to be beefed up. Consider inviting a (responsible) teenage relative, friend or neighbor to help out. Don’t forget about the neurotypical children in the family. Trips require a great deal of patience for them as well, with plenty of anxious moments and unfamiliar territory. The added work that a special child requires must be tempered with attention to everyone’s temperament and needs. An affected child might want to go on the same ride over and over, while the other children need to have the freedom to experience a wider selection of options.

Meals are important part of any holiday, and the unique nutritional requirements of children on the spectrum puts extra stress on an otherwise enjoyable experience. Consider bringing along some digestive enzymes should the child ingest an increased load of really allergenic foods. It may be prudent to double the dose of probiotics during the holiday. When the child’s behaviors indicate a possible yeast outbreak, it may be worthwhile to speak with your doctor about an antifungal agent.

This advice is meant to help make your family holiday less stressful for everyone. You and your children can have more fun when you don’t expect things to turn out perfectly. I invite your comments and helpful advice to make this holiday season more successful and fun for everyone.

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27 Responses to “Coping With The Holidays”

  1. Martinez' says:

    Hi Dr. Udell. Love the idea of the blog! Very good article and I like alot of your suggestions. We just got back from Disney – MGM actually and we had a good time. The boys do pretty well. They didn’t put the 3d glasses on in the 3d muppet movie but still really enjoyed the show; they weren’t too fond of seeing handy manny and mickey mouse live (even though they love it on the t.v) but with our support, they sat through it. And they LOVED the car and stunt show – go figure, it is sooo loud with fake guns firing, fireworks and flames but it turned out to be their favorite – no cries, no fears – they loved it. You just never know sometimes?! I like taking these “risks” because I feel exposure to things is important. Looking forward to seeing you soon to see what you say about the boys and where to go from here. They have, and continue to, come a long way!! Keep blogging!!!

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Brian D. Udell MD
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