Autism - shoes help!

[SleeplessInWherever]

Hoping for advice/some recommendations, if anyone has any!

DS (9) has complex autism, global delay and ADHD. He spends most of his time at school outside, because he needs regular movement and it helps him regulate. If he’s kept inside his behaviour escalates, and being brought back in can lead to meltdown if he’s not “ready.”

Anyway. The last month or so school are having an absolute nightmare keeping his shoes on his feet. He takes them off, but mainly only outside. He’s only doing this at school.

In the last month he’s sprained both of his ankles. Both times at school, both times when without shoes. He runs around outside without shoes on and goes over on his ankles.

We’ve tried switching from Velcro to laces. We’ve tried boots instead of trainers. We’ve tried double knotting and asking them to do the same after changes etc.

My view is that he shouldn’t be outside without shoes on because of the obvious risk, and the very second he takes them off - take him in. But because of the behaviour that presents they’re reluctant to enforce it.

Today at handover they said he’d had a challenging day, refused to wear shoes so repeatedly and with such a fight that they “gave up.”

What I could do with knowing is:

1. Beyond what we’ve already said or tried, what can we do to make sure he keeps them on?

2. Do shoes exist that it is not possible to get out of without adult help?

We had to take him to A&E two weeks ago to check one of them wasn’t broken, so behaviour aside, this cannot continue.

I presume he hates the feel of standard shoes? What about barefoot shoes?

Honestly I think it’s behavioural.

The shoes he wears for school he wears with us on a weekend and never attempts to get them off. He keeps them on in all other settings, indoor and outdoor, regardless of who with.

The only common denominator at school is that he’s there. Even the tarmac of the playground is obviously just tarmac, and he doesn’t take them off in other playgrounds.

Seems too specific to be sensory?

It could still be sensory related. The ability to tolerate things can be reduced by other overwhelm. If DS is otherwise overwhelmed by being in school, his tolerance for footwear may be reduced.

Or rather than sensory in terms of DS struggling with having the shoes on it could be sensory related to the need to seek sensory input by going barefoot. The stress of the school environment could be why DS seeks this input there and not elsewhere.

That’s a fair point, I hadn’t thought of that. Thanks, and @PragmaticIsh . I have started having a look at barefoot shoes.

He is in the same class as last academic year, same teacher, but totally different kids as his previous cohort all moved up. He seems to be settled okay, but without being able to ask him - it could be that, alongside the additional challenge sitting and learning things presents him!

Tbh I was disappointed with the “gave up” comment. I’d prefer not to “give up” on his ankle structure.

It’s becoming something of a back and forth game, by all accounts, that just leads to escalation. I can see why you’d be tempted to give up after a full day of it, but I’d also prefer not to subject him to the stress of ankle X-rays every fortnight.

Your disappointment is understandable.

I would ask the school for a copy of the risk assessment and a meeting.

Are you sure that he is spraining his ankles just because he is not wearing shoes? My DS has never liked shoes. Even age 16 he only wears shoes and socks when he leaves the house. He has never injured his ankles. Could your DS have a medical condition that causes him to sprain his ankles more often? Over pronation? Hypermobility?

Potentially - my partner has EDS, so there’s potential that he does have hypermobility that’s making it more likely he goes over on them.

I think it’s likely to be a combination of both - more likely to happen when not wearing shoes because of the lack of support on his already affected joints.

He’s got his paediatrician review next month so we plan to bring the EDS/hypermobility up then!