Emergency Preparedness Shelter Toolkits

• A shelter is a place that you can go to during natural disasters or conflicts like when something happens to your home. The purpose is to provide personal safety, or protection from the weather, and disease prevention. A typical stay is for 12-72 hours (about 3 days) but can be longer when needed.
• Shelters provide basic needs such as a safe space to get away from the emergency, restroom facilities, water, food, diapers, hygiene products like toothbrushes and soap, and medical assistance when necessary.

A person would go to a shelter to seek safety from multiple different events, such as:
Natural disasters (hurricanes, wildfires, floods, tornadoes, etc.), house fires, homelessness, and abuse.

• Shelters are there to provide the basic safety of a warm place to eat and sleep. They cannot offer the same types of luxuries or conveniences as an actual house or hotel.
• Shelters can be used in emergency situations and are placed in whatever large buildings are available in the affected area. They are typically in warehouses, office buildings, schools, church halls, tents, etc.
• They can often be crowded, noisy, boring, short-staffed, and with very little privacy. Rooms may be filled with people, cots to sleep on, personal items, and sometimes separate rooms for pets. This all depends on the area you’re in, the conflict/crisis affecting you, and the number of other people affected by it.
• It’s important to remember that you are safe and that being in a shelter is only temporary!

• The staff in shelters are usually made up of county employees or volunteers trained by the Office of Emergency Management.
• Staff help maintain a safe and clean environment while providing food and any medical and emotional support when necessary. They maintain shelter security by keeping the peace, alerting shelter residents of any rules/policies/procedures, and providing conflict resolution.

• Once it is safe to leave a shelter you may be able to return home, depending on the type of crisis that occurred.
• If your house is unlivable, you may be told to seek another shelter or to stay with friends and family.

• If you need extra time to acclimate to changes in light intensity (turning lights on/off,natural light to artificial light):
  Request to have room lighting adjusted to be darker or dim the lighting.
• If you need to fill out paperwork there may be a lot of text with small fonts:
  You can request breaks when completing paperwork or the option to fill out thepaperwork with larger and simpler text.

• If competing sounds are an issue (i.e., multiple radios/songs on, people talking, etc.):
  Ask for a quiet place to go when talking about important things and make sure no more than one person is talking at a time.
  You could also ask to use visual supports or index cards with simple images to explain directions if that is better than directions being told to you.
• If low-intensity or common sounds are frustrating (i.e., people crunching food, sniffling,whistling, computer sounds, fluorescent light buzzing):
  Ask for noise-cancelling headphones or earplugs.
  Give time to acclimate to sounds first by separating with distance or a door/another space first.
  Ask if there is a quiet place to go if the shelter gets too loud.

• If the space feels crowded or there are many people around:
  Ask for people to provide an arm’s length distance of personal space.
  Ask for a weighted blanket.
  Take movement breaks (examples: wall push-ups, jumping activities, or yoga) if you are doing a task that requires sitting for a long time.

• If the space is crowded and others are bumping into you or brushing up against you and that causes distress:
  Ask for a separate space away from others.
  Ask for fidget toys or weighted blankets (if they are helpful for you).
• If you have specific preferences for the texture of foods, bedding, or clothing:
  Alert staff to your preferences and request different options, if available.
• If you are sensitive to being touched when getting first aid for cuts, bruises, or injuries ordo not like the sensation of certain things (latex gloves):
  Alert staff to your sensitivities and what works best for you.
  Ask for fidget toys (if helpful for you).
  Request visual or verbal explanations of what aid is being provided before staff touches to provide care.

• If you are overwhelmed by a variety of foods and scents:
  Ask to eat in a spot further away from strongly scented foods
  and drinks.
  Ask to keep snacks in your room (if you have a private room) to be able to eat away from others.
  If you prefer to stick with a set routine for mealtimes/snacks or have preferred cups/utensils:
  Let the staff know your typical routine and preferences, including cups, straws, plates, or utensils that you prefer.
• If you have sensitive tastes:
  Ask for different flavors of toothpaste.
  Let the staff know your food/drink preferences

• If you engage in stimming behaviors to self-regulate or calm yourself:
  Ask for space to allow movements such as jumping and spinning.
• If you have trouble with steps or uneven ground:
  Ask to use an elevator, ramp, or escalator if available.
  Ask for help walking on uneven ground.
• If the shelter has bunk beds:
  Request a lower bunk.

• If you have sensitivities to certain smells or odors:
  Ask for neutral personal care items (deodorant, lotion, etc).
• If you have smells/scents that are calming to you let staff know so they can try to provide those.
  Ask to have a room away from eating spaces.
  Ask staff to let you know before they use alcohol wipes, disinfecting sprays, bleach, or other cleaning supplies so you can leave the area if overwhelmed by the smells.

It is natural to experience emotional ups and downs. Life events affect everyone, and some people are more vulnerable to experiencing mental health challenges than others. If you have not experienced mental health concerns in the past, you may want to be aware of some common signs in case you experience any of these in the emergency shelter.

Some common signs of mental health concerns may include:

• Sudden changes in behavior.
• Withdrawal.
• Lethargy.
• Shutdown.
• Increased repetitive behavior.
• Agitation.
• Poor self-care.
• Feelings of hopelessness.
• Change in
  communication.
• Increased sensory challenges.

Anxiety is a commonly occurring mental health diagnosis. New or stressful situations may make anxiety even worse. If you are in an emergency shelter, you likely have gone through stressful and/or traumatic events. It is normal to experience anxiety in these situations.

Signs of anxiety may include:

• Feelings of dread, excessive fears, or looking for signs of danger.
• Trouble concentrating.
• Feeling irritable.
• Brain fog or feeling like your mind is blank.
• Dizziness.
• Fatigue.
• Difficulty falling asleep.
• Muscle tension and twitching.
• Rapid heartbeat.
• Rapid/shallow breathing.
• Trouble breathing.
• Upset stomach or nausea.
• Sweating, shaking, wringing hands.

Everyone feels sad or down sometimes, usually when something bad or sad happens. When you have gone through a stressful or traumatic situation, such as being in a shelter, you may start to feel depressed. Below are some of the signs of depression:

Mind:

• Feeling tired, having no energy.
• Changes in how much you sleep, either a lot less or more.
• Changes in how much you eat, either a lot less or more.

Thoughts/Emotions:

• Not interested in favorite subjects or activities.
• Thoughts about death or not wanting to be alive.
• Don’t want to spend time with friends or loved ones.
• Easily frustrated, irritable, and easily upset about things that don’t normally bother you.

Body:

• Not caring about taking care of your body like brushing your teeth or showering.
• Feeling achy or having pain you can’t explain.
• Having an upset stomach.

Staying in an emergency shelter can be a very stressful time. Even if you usually handle stressful situations well, you may end up having a hard time managing being in a shelter. It can be helpful to have a safety plan in place for shelter staff to know the best way to support you if you end up in a crisis.

In a crisis, it is important to make sure that you are safe and feel safe.

• Use strategies that you have learned to keep yourself calm. These can include fidget spinners, deep breathing, and other things that you find relaxing.
• Be sure to ask any questions. Shelter staff are there to support you.
• If you are having a hard time responding, try to find out why that is. If you are having ahard time talking, it may be helpful to write things down to communicate with shelterstaff. Reflect and practice relaxation techniques. Shelter staff can assist you if needed.
• If you feel you need to speak to a mental health professional, let the shelter staff know. They can connect you with resources to help.
• If you have a safety plan or ways that are helpful to support you if you are in crisis, consider sharing that information with shelter staff when you arrive. If you don’t have a plan in place, you can connect with the disaster mental health staff members on site for assistance and support.
• Identify a coping zone somewhere in the shelter with help from the staff. This coping zone should be a quiet place where you can relax, practice coping skills, and practice self-care during stressful situations.
• Create a list of coping strategies that can be used. Some strategies could include: counting back from 10, listening to music, reading, playing a game, journaling, drawing your feelings, yoga, or positive self-talk.

Getting the right amount of sleep is always important, but even more so when in stressful situations. Individuals with autism are more likely to have sleep issues.

Some things that may help your sleep include:

• Sleep environment:
  The place you are sleeping should be as dark, quiet, and cool as possible. You may be more sensitive to noise or have sensory issues. The environment should be adapted or have adaptations available to make it as comfortable as possible. If you are having a hard time sleeping due to sensory issues, talk to shelter staff to see if they can help you.
• Bedtime routine:
  The routine should be predictable as possible, somewhere between20-30 minutes, and include relaxing activities such as reading or listening to quiet music. Avoid the use of electronics close to bedtime such as TV, computer, and video games that can be stimulating making it difficult to fall asleep.
• Sleep\wake schedule:
  The schedule, including your bedtime routine, should be regular with not much of a difference between the weekday and weekend schedule.
• Exercise:
  Daytime exercise can make it easier to fall asleep and exercise tends to lead to deeper sleep. Avoid exercising too close to bedtime as it can make it difficult to fall asleep.
• Avoid caffeine:
  This is important throughout the day but particularly at bedtime, which can make it difficult to fall asleep. Caffeine is found not only in coffee, but also in tea, chocolate, and some sodas.

Individuals with autism are more prone to gastrointestinal (GI) issues. If you have GI issues, it is important to share those with shelter staff if you have specific needs and supports around those issues.

Gastrointestinal issues may include:

• Constipation.
• Diarrhea.
• Gas.
• Abdominal pain.
• Painful stool.
• Nausea or vomiting.

Stressful situations, such as being in a shelter, can make gastrointestinal symptoms worse. Some ways to address gastrointestinal issues include:

• Making sure you have enough fruits and vegetables that you like to eat.
• Taking any vitamins or minerals that are prescribed.
• Other helpful tools that you have learned help regulate your gastrointestinal issues.

In a shelter, there may not be foods that you like to eat or textures of food that you do not like. If you have specific dietary needs, you need to let shelter staff know so they can help support you to get the foods that you need.

Individuals with autism may have health issues including allergies that shelter staff will need to know about. If you were not asked about your medical history, including allergies, please let shelter staff know if you have specific allergies.

• If you are sensitive to fabrics, let staff know so they can get you the right clothes and bedding.
• If you have food allergies or sensitivities, make sure to alert shelter staff so they can help get you appropriate, healthy foods.

• If you are finding it difficult to communicate in the environment, ask shelter staff if there is a quieter place you can go to continue the conversation.
• If you are having a hard time answering the questions from the shelter staff, be clear about why you are having a hard time answering them.

• “Can you please give me a few moments to think and respond to your questions?”
• “I am having a hard time answering all these questions. Can we take a break from these questions for now and get back to them?”
• “I am getting confused with some of these questions. Can you simplify the question for me?”
• “I am not sure how to answer that question. Can you provide a few options for the question for me?”
• “Can you please be more specific when you ask me questions? For example, “What did you order for lunch?” instead of “How was your lunch?”
• “I don’t understand what you are trying to tell me. Can you explain it to me in another way? I may understand it better written out, drawn, or bullet points”

• Trauma is an event that occurs and may affect people in different, often negative ways. These experiences can make you feel entirely helpless. Trauma may happen from serious injuries, death, violence, or being in a shelter.
• Trauma can have an impact on someone’s life in different areas. This can include your physical and mental health, emotions, relationships with others, and/or your behavior. You may have trouble eating, sleeping, or doing your usual daily activities.

• Directly as an event happens. This means that you may have immediate impacts from going through a traumatic event.
• Sometimes it takes longer for people to be impacted by trauma. You may experience symptoms days, weeks, or months after the event happens.
• Other times it is a combination of these two. People are immediately affected as the event happens and also can continue to affect people for days, weeks, or months after.
• Trauma can affect people after the event because specific people, places, and situations can be reminders of it. Reliving the trauma through memories is also common for some.

Resilience means staying calm and in control when faced with a challenge, such as being a shelter. It can help us understand trauma and get through tough times in healthy ways. Being able to build your resilience can help cope with stressful situations like being in a shelter. Below is information about resilience skills that can be used to help you cope with the stress of being in a shelter and build your resilience.

• Tracking: Pay attention to what is happening in your mind and body. Focus on thoughts and sensations – things you can see, hear, smell, taste, and touch. You can use tracking to notice when you may be feeling stressed (increased heart rate, negative thoughts, clenching fists, etc). When you use tracking to notice these sensations you can then use coping skills to help with the stress. You can use tracking to notice pleasant thoughts and feelings too, and focus on those good things to help you cope and increase your resilience.
• Resourcing:
  Use different resources to help you feel better. You can use things that are pleasant or make you happy like music, pictures, people, things, and ideas like happy memories. If you’re feeling stressed you can focus on a favorite thing (in real life or imagination) and pay attention to the details. If your favorite thing is the beach, you can close your eyes and imagine the sound of the waves, the sun on your face, the feeling of the sand, the breeze across your skin, and the smell of the salty air. Pay attention to how those things make you feel, and focus on the ones that make you feel happy.
• Grounding:
  Focus on where your body is touching different surfaces. You can use grounding if you’re standing, sitting, or laying down. Feel the pull of gravity on your body. Use tracking to pay attention to how your body feels, and focus on the things that feel good or pleasant.
• Gesturing:
  Certain gestures can make people feel happy or calm. When people are excited, they sometimes jump up and down or throw their hands in the air. These are gestures. If you have movements that you do when you’re calm or happy, you can use those when you are feeling stressed. This can help your brain shift from being stressed to calm and happy. When you’re using gestures, pay attention to different thoughts and feelings in your body and focus on what feels good.
• Shift and Stay:
  If you’re having negative thoughts, try and shift your mind away from them. Start to focus on positive or neutral thoughts. You can use the other skills above to help you shift to more positive things (like memories of a favorite place, your favorite music, etc). Keep your mind focused on these new thoughts by thinking about as many details as possible and stay focused on these positive thoughts.

This app explains resiliency and resilience skills in depth. Users can record where they are in their Resilient or “OK” Zone as well as create a list of their resources with pictures to help them feel better.
This is a free app to download on your phone or available to access online at www.ichillapp.com.

• Preferred Nickname
• Things that help me/them to feel calm (pets, colors, objects, interests)
• Things that make me/them uncomfortable, afraid, and/or upset (loud noises, crowded spaces, animals, routine disruptions)
• Signs that I/they might be uncomfortable or in a bad mood (pacing, crying, disengaging, angry)
• Places I/they can go in this setting where they can feel safe and calm
• People I/they like to talk to
• Names and phone numbers.

• How do I/they communicate with others? How do I/they receive information from others? (ASL, verbal language, PECS, tactile objects/cues, interpreter)
• Things I/they commonly say or do and what they mean (I hold out a cup when I want a drink, I sign “I like you” when I feel safe)
• Any other communication needs?
• My/their favorite things (people, foods, types of clothing, TV/movies, music, hobbies, high-interest topics, etc)
• How to introduce me/them to new people/items/locations/transitions/changes in schedule, etc.?

• Important Family/Friends Contact Information
• Supports Contact Information (Coordinator, Case Manager, Direct Support provider, educator, unpaid supports)

• Primary Care Doctor Contact Information
• Psychiatrist/Specialist Contact Information

• An autistic person may see different patterns on walls, clothing, and furniture that they aren’t used to. That can be distracting and disorienting.
• An autistic person may need extra time to acclimate to changes in light intensity (turning lights on/off, natural light, artificial light).
• You may want to ask to adjust the room lighting to be darker or dim the lighting.
• If available, you may want to ask to use shades to dim overhead fluorescent lighting.
• Light glare from flooring, TVs, digital screens, and other reflective surfaces could be a challenge.
• They may be asked to fill out paperwork. This can be a stressful task due to the small font and dense text. Suggest a movement break or check for an option with larger and more concise text.

Suggestions:

• Use a phone to show pictures and create a sequence of steps for what the individual should expect to happen.
• Use sunglasses to alleviate brightness.
• Lava lamps and slow-moving videos or projections can reduce stress.

• Advise others to wear odor-neutral deodorant and avoid strong-smelling lotion and perfumes.
• Develop a social story about potential experiences prior to entering a shelter or crowded space.
• Is it possible to move into a room or area further away from eating spaces like cafeterias?
• Ask about a shelter room/space with a window that can be opened/closed as needed.
• The scent of alcohol wipes, disinfecting sprays, bleach, or hand sanitizer could be overwhelming. Give a warning prior to cleaning a room/space, or post a sign on the door outside of the room to indicate when it was cleaned.
• Be mindful of trash areas with some scented garbage bags being overly scented/ fragranced.

Suggestions:

• Suggest the individual have access to essential oils or other pleasant-smelling items (Also have an item to put the scent on, including cotton balls, perfume strips, or other items).
• Record the individual’s preferred calming smells and any overwhelming scents/smells.
• Determine if unscented soap and unscented garbage/trash bags are available.
• Offer a variety of scented hand sanitizers.

• Competing sounds can be an issue (i.e., multiple radios/songs on, people talking, etc.)
• There may be low-intensity or common sounds that can be frustrating (i.e., people crunching food, sniffling, whistling, computer sounds, fluorescent light buzzing).
• You may want to give the individual time to acclimate to sounds by separating with distance or a door/another space first.
• Suggest fidget toys (stress ball, putty, etc.) or having a preferred object for comfort.
• Tell those helping in the shelter what is comforting and would help the person relax.
• Tell staff what words or visuals can help explain that sounds are “safe” or “okay.”

Suggestions:

• Noise-cancelling headphones (short-term strategy, long-term use can increase sound sensitivity).
• Fidget toys (stress ball, putty, etc.) or have a preferred object for comfort.
• Have visual supports or index cards with simple images available to explain directions.
• You may need to provide verbal support. Remember to speak slowly, and give time for a response to questions. You may have to repeat yourself.
• No more than one person should be talking at a time. Suggest calming music.

• Areas with a variety of foods and scents could be overwhelming. Consider offering a spot away from strong smells.
• Identify a person’s typical mealtimes. Changes to that routine can be challenging or upsetting.
• Have snacks in their room in case public eating areas are overwhelming.
• If in a shelter, consider the available foods and what an individual will be able to eat and drink on a daily basis due to sensitivities.
• Consider having toothpaste options as some of the mint-based flavors can be too strong (i.e. sweet-based flavors).
• Remind staff to allow for more time during meals or breaks as the individual adjusts to the new environment.

Suggestions:

• Have a variety of snacks available (i.e., bread-based, starchy, or salty food).
• Be aware of the individual’s preferred/non-preferred foods and scents.
• Be aware of the individual’s normal meal/snack time and routine.
• Have cup and straw options available.

• There may be situations in which the person is inadvertently touched in crowded spaces (bumping into, or brushing up against people). This can cause physical pain and distress.
• Individuals may have different preferences for the texture of foods and may express dissatisfaction with food that is unrelated to taste and due to texture.
• Individuals may react strongly to being touched on or near cuts, bruises, or injuries, or they may seem not to notice such injuries.
• Various textures (clothing and bedding fabric, medical gloves, furniture) may cause discomfort/pain and lead to avoiding/pulling away from textures.

Suggestions:

• Provide options for fidget toys with different textures such as rubbery, stretchy, smooth, plastic, beaded, etc.
• Visual cues during dressing, such as a mirror, can help visualize touch sensation.

• Remind others in the shelter to provide an arm’s length distance of personal space.
• Ask about heavy work options between activities or tasks (options can include helping to set up chairs or carrying a heavy item.)
• Provide a weighted blanket or another weighted item to place on the lap.
• Make sure to keep the space clear of any fall/trip hazards.
• Encourage movement breaks (examples: wall push-ups, jumping activities, or yoga) if doing a task that requires sitting for an extended period.

Suggestions:

• Have a weighted blanket, lap pad, or wrist/ankle weights.
• Stretch bands (i.e., can be used as fidgets to pull with hands in opposition or can be placed around chair legs to push against, can wrap around door handle for pulling/stretches, etc.)
• Box with sand for increasing weight against hand muscles.
• Fidget toys or stress balls.
• Soft lead 2B pencils (if the individual is writing too hard and creating holes in the paper).
• HB pencil (if the individual is writing too lightly and the handwriting is illegible).

• Inform staff the person may need space for movements such as jumping and spinning because they require movement to stay calm or to be alert.
• Steps or uneven ground may be challenging to navigate and cause imbalance.
• Request seating options that provide support/stability or opportunities for a movement like a rocking chair or cushion.
• If a shelter has bunk beds, consider the option of the bottom bunk to allow the person to be closer to the ground if they have a fear of gravity.
• Make sure to have railings or have someone walk with them when going up/downstairs to assist with balance.
• Inform shelter staff about their preference for using stairs, elevators, or escalators.

Suggestions:

• • • Chairs or large exercise balls that rock can be relaxing and calming for hyperactivity to movement. Make sure an individual can maintain his or her balance (some individuals also prefer chairs that spin).
    • Provide stable four-legged seating with back support and limited movement for hypersensitivity.
    • Provide a heavy blanket or bean bag chair to provide touch and pressure input to an individual’s body to help calm an overreaction to movement.
    • Provide opportunities to walk around or do light exercises to help support attention and focus.
    • Play preferred music to help soothe and calm.

It is important to know yourself and how you tend to react when you see an individual escalating or in crisis. Identify some of the feelings you may have when you see an individual escalating:

• You may feel anxious
• You may feel frustrated
• You may feel responsible for the behavior
• You may feel helpless

Now that you’ve identified your potential feelings, try to put any reactions or judgments aside. You can process these feelings with a supervisor or colleague at a later time.

First, it is important to ensure an individual’s safety as well as your own when an individual is escalating, in crisis, and de-escalating. If it is appropriate, and if you can, identify and remove the triggers causing the crisis.

• Be familiar with an individual’s Crisis Intervention Plan and utilize your own crisis intervention training when you recognize that a person is escalating or in crisis. Talk to the person you support and learn about his or her triggers. You may not know what they consider a crisis, and you need to know what a “crisis” looks like to that person.
• Be clear and concise with your language, if you are speaking to the individual during the escalation, crisis, or de-escalation.
• Be aware of your voice tone and volume if and when you are speaking to the individual.
• Be aware of your body language around the person.
• If appropriate, ask questions to determine what the person needs you to do to help them through the crisis. It is good to determine where the person would like you to be, whether or not you should speak, and if there is anything you can do to assist them.
• Be able to recognize when it is appropriate to introduce coping strategies during the escalation, crisis, and de escalation. Ask for help when needed through the use of supervisors, the individual’s natural supports, and crisis intervention services.

• A good first step in crisis prevention is to identify someone’s potential triggers.
• You can do this by asking the person, their family members, colleagues, or others who know them well. Then plan accordingly.
• Seek assistance from your supervisor and colleagues whenever you observe increasing behavior challenges in someone you’re supporting.

What is happening in the mind and body? Focus on thoughts and sensations – things they can see, hear, smell, taste, and touch. Use tracking when they feel stressed (increased heart rate, negative thoughts, clenching fists, etc). When using tracking to notice these sensations, also use coping skills to help with the stress. Use tracking to notice pleasant thoughts and feelings, too. Focus on those good things to help cope and increase resilience.

Use different resources to help them feel better. Utilize things that are pleasant or make them happy like music, pictures, people, objects, and thoughts like happy memories. If they’re feeling stressed, focus on a favorite thing (in real life or imagination) and pay attention to the details. If their favorite thing is the beach, have them close their eyes and imagine the sound of the waves, the sun on their face, the feeling of the sand, the breeze across their skin, and the smell of salty air. How do those things make them feel? Focus on what makes them happy.

Focus on where their body is touching different surfaces. They can use grounding if they’re standing, sitting, or laying down. Do they feel the pull of gravity on their body? Use tracking, and focus on the things that feel good or pleasant.

Certain gestures can make people feel happy or calm. When people are excited, they sometimes jump up and down or throw their hands in the air. If they have movements they do when they’re calm or happy, do those same movements when they’re feeling stressed. This can help the brain shift from being stressed to calm and happy. When gesturing, pay attention to different thoughts and feelings in the body and focus on what feels good.

If they’re having negative thoughts, try and shift their mind away from them. Start to focus on positive or neutral thoughts. You can use the other skills above to help shift to more positive things (like memories of a favorite place, favorite music, etc.). Keep their mind focused on these new thoughts by thinking about as many details as possible and staying focused on these positive thoughts.

• Use the person’s name at the beginning, so it’s clear you are addressing them.
• Help the person feel comfortable by talking about a special interest or topic.
• Be aware of your environment. A noisy, crowded room may make communication difficult.

• Give a longer window to respond to a question.
• Don’t ask too many questions.
• Keep them short and close-ended.
• Offer options or choices.
• Be specific–e.g. “What did you order for lunch?” instead of “How was your lunch?”

• Don’t rely on non-verbal cues, such as eye contact, gestures, and tone of voice.
• Many with ASD report eye contact as difficult and uncomfortable.

• Use concise sentences to prevent word overload.
• Pause between ideas.
• Be literal. Avoid irony, sarcasm, figures of speech, or exaggerations.
• Explaining something complex? Write it out, make a visual, or number the topics. Allow the individual time to ask questions and process what is being said. After, check for understanding.

• Sensory or environmental variables.
• Emotion or tone of situations.
• Social variables.
• Anxiety.
• Sleep or fatigue.

• Communicate purposefully and politely. Eliminate unimportant conversations that create awkward interactions. Some people may be uncomfortable with small talk.
• Include the individual in every interaction they should be included in.
• Use clear, concrete language (no idioms or vague abstract language, ex. “What’s Up?”)

A person may seek sensory input by:

• Seeking sound: Banging objects loudly, turning up the volume.
• Constantly moving: spinning, rocking, etc.
• Mouthing: Showing a preference for spicy food or other strong flavors, putting things in their mouth.
• Smelling or sniffing objects.
• Excessive touching: Rubbing something with texture over and over again

• Bothered by loud places, particular noises (e.g., squeaky doors), fluorescent lights, scented products, and certain fabrics or textures.
• Food sensitivities (strong flavors or certain textures) may lead to a limited diet.
• Interference with hygiene (hair brushing and/or teeth brushing may be painful).
• Sensitivity to touch.
• Fine motor difficulties (handwriting, buttons, shoelaces, etc.)
• Dislike of certain odors or smells

• Covering of ears/eyes.
• Putting head down.
• Wearing a hood, sunglasses, headphones, or hat indoors.
• Appears stressed or anxious.
• Appears to be in pain.
• A marked change from usual behavior.
• A change in communication style or routine.
• Elopement.