Transitions

WRITTEN BY AMY HOGEN MS, OTR/L AND SYDNE STEINBACH, OTD, OTR/L

Transitions…they happen countless times a day, so many times that we as adults may not even think much of them. A transition is the time between stopping one activity and starting the next activity. This takes some planning ahead, which requires an awareness of time and schedule. We understand the intensity of transitions for little ones and have good strategies for helping young children by setting timers and singing songs.

How does neurodiversity impact our ability to transition? What if children STILL need help to stop what they’re doing or get started on a new task long after the clean-up song has lost its magic? Neurodiversity such as ADHD, autism, learning disabilities, being gifted or highly intelligent can make transitions much more difficult due to the multi-faceted demands that transitions place on the brain.

Neurodivergent brains are often very good at extreme focused attention, known as hyper focus. This extraordinary attention to a specific activity or strong preference for specific and familiar activities, can make transitions uncomfortable, surprising, confusing or downright distressing. Neurodivergent brain wiring can also be very literal when it comes to organization, so if a transition is out of routine, it can be very frustrating and overwhelming. This can result in a big emotional response.

Difficulty with transitions can look like being very disorganized, irritable, using high levels of negotiation or simply refusing to participate. In teens and emerging adults this shows up as anxiety or inflexibility; being controlling or rigid to maintain a sense of order and organization or simply avoiding anything that requires the energy to change.

Once we understand that mentally shifting gears or moving from one activity to the next can be stressful and discombobulating for the ones we care about with neurodivergent thinking, we can bring in some simple strategies to compassionately support transitions with less stress for everyone.

With older children and teens:

• Visual schedules can be helpful for consistent routines such as morning, after school or bedtime. This is a sequence of pictures, drawings or words to show a child what is coming.

• Offer choices. “You can get dressed and ready for school before breakfast or after breakfast.” Regardless of what they choose, the task is completed but the child/teen has autonomy.

• Create organization techniques so that your teen knows where items go. Label containers and shelves according to their contents.

• Budget more time than you think. Individuals with neurodivergence have difficulty with time management. If you think something may take 30 minutes, budget extra time in case it takes longer.

• Use simple language. Instead of providing multiple directions at one time, give oneto-two directions at a time. “Get your backpack, then get your shoes on.”

• If your child or teen is distracted or doing a preferred activity, gain their attention prior to providing them with directions.

For emerging adults:

• List out the specific tasks or steps to prepare for entering your transition.

• Create reusable checklists either daily or breaking your day into portions.

• Create phone alarms or reminders for upcoming events or tasks.

• Work backwards. If you have to be at work at noon and you live 30 minutes away, consider that it takes one hour to shower and get ready, and that puts you at 10:30 a.m. Prior to getting ready, you want to do laundry and vacuum, which typically takes an additional hour. To complete all of those tasks and get to work on time, you need to start at 9:30 a.m.

Amy Hogen is a long-time pediatric occupational therapist and mom to two ‘neuro-spicy’ teen boys. You can find her at Bozeman Health Pediatric Rehab or floating the river on her paddleboard.

Sydne Steinbach is a new graduate occupational therapist working at Bozeman Health Pediatric Rehab. She has a passion for helping families be successful. Being raised in a small town in Montana created a love for all Montana has to offer. Outside of work she enjoys hiking with her fiancé and dog or baking sourdough.