Help with decision making

[anon2022anon]

Hi, I have a 5 year old awaiting assessment for additional needs. One of her traits that seems to affect her happiness a lot is decision making- she gets anxious that she's choosing the wrong thing, and if she's in a vulnerable mood it can make her cry to have to choose which socks to wear, for example. This isn't all the time, thankfully, but generally, in a morning, it will be at least a 2 minute decision whether to have cereal or pancakes, multiplied by a lot of small decisions in the day.

Does anyone have any resources that may help her develop these skills?

Am I doing the right thing by keeping on presenting the options for her to choose? I do always try to ask her to choose, except for the worst days, when she just needs to be told what to wear/ do as she gets so upset with indecision. Thankfully, these aren't often.

Adding a time limit doesn't really help, her anxiety visibly raises if something like a sand timer is used for activity timing.

Thanks

Apologies if this is the wrong area, it felt the most relevant

We have similar at home, I tend not to ask questions I will make a statement about what he's wearing, what our plans are what he's going to eat etc. If he wants something else he will say. Sorry if that's not helpful in your situation. There are very few choices I need him to make really so I think why add to his load 😀

Some find making choices ahead of time helps because there isn’t the same pressure and perceived demand. For example, could you get clothes ready the night before? Would DD find it easier to choose breakfast the night before or have the same breakfast each school morning? It doesn’t work for all but it is worth a try.

It is worth reading about demand avoidance.

Has DD had a SALT assessment?

@Bobobab I have thought about whether to do this, but I wasn't sure whether it's a skill that needed strengthening through practicing, or something to avoid, hence the question! For the main, most decisions cause uncomfortable- ness, not outright upset, where I do stop the process.

@StrivingForSleep for the most part, she chooses the same things anyway, almost always pancakes for breakfast. But if I was to say to her I'll go downstairs and get your pancakes ready, she would tell me she hasn't chosen what she wants yet. Followed by 60 seconds of umming, then telling me pancakes!

I think we will move the school uniform skirt or trousers decision to the night before, you're right, it takes the time pressure off. Shes at a stage where the jersey trousers are clearly what she prefers in a sensory manner, but other girls are wearing skirts and tights, so it's a decision that's seriously weighed up by her.

No SALT referral, I'm assuming because her language is good and she can tell you what she needs? She was referred to early years support in preschool, who agreed she needed assessment and referred her, but it's gone no further yet, and she's now at school. Nothing has been raised at school yet, and although they know the concerns, I presume she's masking quite well and just following the class. I don't think there is much decision making or free will within foundation year, so this won't be something that is cropping up too often for them.

I'll have a look at demand avoidance too, thanks

SALT is about more than the physical ability to speak.

Speak to the school. They should be providing support.

It is also worth checking if your ICB commissions sensory OT on the NHS. Not all areas do, but if your area does, it is worth looking at a referral.

You could also try using visuals to make choices: so she chooses pictures and sticks it on a chart, and if she can't make a choice or doesn't want to, she can maybe put up a picture of you to choose for her. Visuals can be really helpful, even for very verbal children.

It's really normal for kids with ASD to have spiky speech and language skills. My DS's vocab is above the 90th centile but he really struggles asking for help, turn taking, listening to others responses to questions.

@StrivingForSleep Thank you. I'm happy to speak to the school support, and I think it's time to schedule in a catch up anyway, but what should they be providing/ what do I need to ask them for?
I would like to speak to them anyway about social skills/ friendships/ playtimes, about previous concerns about processing instructions. I have brought up before her anxieties around decision making, and they said they would be mindful around free play time, but nothing else since. What help should I be asking for that school are best place providing/ referring for?

Thank you for any guidance. I'm a bit lost with all of this, and I feel like a child who on the surface is coping well is probably going to struggle in getting help, or knowing whether they even need help sometimes. The preschool were very proactive in coming to me with concerns, but now at school, although it's a very good school, because of ratios etc, it feels a bit like they're herding sheep and it's very easy for stuff to go unnoticed.

@BusMumsHoliday thanks. I think mornings are probably the pressure points, as lots of small decisions in a short period, so you're right, visuals may help, as well as moving decisions to the night before.
A chart showing skirt/ trousers, breakfast choices, etc to be set up the night before might help reduce the pressure some.

Some great suggestions already re choice making including visuals and deciding the night before. For breakfast you could have a Monday to Friday chart where she records her choices.

You could try the You Choose book series with her where she gets used to making choices that don’t directly impact on her day. Other activities e.g. sticker books/ dress a doll type books might help.
I’d also model choice making indirectly for her and explain e.g. I think I will wear my boots today as it’s cold or I need my blue coat today as it’s got a hood and it’s raining.

It does sound like the choice making may be linked to “ getting it wrong/ making a mistake” again try to model this when you can to show that it is ok to make mistakes.

Despite strategies choice making and worrying about mistakes can extend into adulthood. Anything you can do to help or support may help to reduce the impact and hopefully will make your days easier to manage for both of you.

It is often more difficult to get support for DC who mask, but it is possible. Don’t let anyone fob you off by saying this is a home problem.

The school could look at support with anxiety and emotional regulation - do they have anyone who can support emotional literacy work, Zones of Regulation, nurture group, drawing and talking therapy... They can look at supporting decision making - there will be more decisions DD makes during the day than you realise. For sensory issues, do they run sensory circuits intervention. If DD displays demand avoidance, have they looked at how to support that - the PDA society is good for courses/teacher resources. For the friendships/social interaction difficulties, do they run a club for those who struggle, Lego therapy...