Systematic desensitisation

I've worked with loads of autistic children who have fears related to getting their hair wet at bath time, getting their nails trimmed, going into public toilets because of the hand driers and hair cuts is a very common one too.

The key ingredient to successfully tackling all of these sorts of fears is systematic desensitisation.

Stick with me.

Systematic desensitisation is..... a gradual exposure to a hierarchy of anxiety provoking situations.  The child goes through each stage of a hierarchy, only moving on to the next level of ‘anxiety producing’ stimuli when the current level no longer ‘feels threatening.’

We're talking about breaking that bad boy down into tiny baby steps and only raising the bar when your child is cool with each step.

Let's look at an example:

You are scared of spiders….

"Look, there’s a fake spider across the room – Oh, look, the spider is gone. You did a great job looking at that spider."

(A while later) "There’s a spider on the other side of the table, let me take him away for you."

(A while later) "Look, this is my pet spider . . ."

Food Refusal Example

You hate mandarin oranges…..

We know that. We just want you to take a look at this can of mandarin oranges. You’re cool with that? Great! We just want open up this can of mandarin oranges, then. No big deal? Alright, let me put a few mandarin oranges on your plate. No, you don’t have to eat them, but would you pick one up with the fork....

Some common components of systematic desensitisation programs:

  • The reinforcer is typically escape
  • Prompt the completion of the current level – do it FAST and then get the item AWAY (out of sight, typically)
  • Deliver the reinforcer (escape and typically some praise or even possibly something more than just escape and praise, like a treat) immediately following the interaction
  • Typically involves: a task analysis, forward chaining, client calm at each level / step, “fading in demand”

There's no avoiding the fact that this protocol can take time and practise so it's usually very important to partner up with parents so they can help prepare their child before the big day of the actual hair cut in the salon.

If you want to see an example of the types of steps you could create for your child to help them with hair cuts just click this link to download an example of a task analysis.

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