Why Losing Can Lead to Meltdowns in Autism

All kids have trouble learning to lose with grace, but for children in the autism spectrum, losing can lead to an all out meltdown.  A meltdown is different from a tantrum in which the child is in control of his behavior but is acting out to achieve a goal or manipulate an outcome.  A meltdown is the moment at which someone is entirely overwhelmed by emotion and decompensates before your eyes.  The emotional moment may last a very long time; children with autism can take even hours to recover.  

Many children with ASD (autism spectrum disorders) have meltdowns in response to losing a game.  Why?  Here are several reasons:

•  Uncertainty:   Individuals in the spectrum often want things to be routine and predictable.  They have difficulty not knowing the outcome of something ahead of time.  For some kids, if there was a predictable pattern to winning and losing (e.g., I win then you win then I win...), the individual would do better.  But that is the point of the game for most people; the outcome is uncertain and captivates our attention.  What is going to happen?!  For the individual with ASD, the uncertainty is stressful.
• Concrete: Good vs Bad --Concrete thinking is common in the spectrum as well.  Your child may categorize everything into good or bad, or other black-and-white categories.  As my son was growing, he would ask the same thing of me ("Is that person a good guy or a bad guy" or "Is that a good word or a bad word").  It is difficult for your child to, on the one hand, know that winning is the object of a game (no matter what adults say to the contrary) and also realize she is either a winner or a loser, good or bad.  When she uses all her efforts to get into the "good" category and fails, this is overwhelming.  
• Fixed Beliefs --Many individuals in spectrum fixed beliefs that have no clear basis in reality.  They may firmly believe with all their being that something makes the team that is playing good or bad.  For example, they may be extremely attached to the blue uniforms of a team on television, and melt down if the blue team doesn't win.  I have heard some kids say, "I don't know why, but I just feel like it is really really important for the blue team to win."  It is common for people in the spectrum to be unable to distinguish what is "really important" and what is not. 

This leads us to the topic of Emotional Control.  You can think of emotional control as part of the overall concept of executive function which is impacted by the center and front of the brain.  For a good description of emotional control, see Dr Dawson and Guare's descriptions in their books at Smart but Scattered Kids.  Executive function is a significant difficulty for individuals in the spectrum, and emotional control is a big part of that challenge. 

People who have emotional control difficulties may have different manifestations.  In the presence of overwhelming situations,  they may:

• Shut down (withdraw, lose their words, freeze, be unable to act)
• Act Out, Explode, or Meltdown (pushing someone away, crying, yelling)
• Become very anxious (significant fear, worry, and upset)

Because they are less able to manage their own emotional and physical experiences, they often become overwhelmed by emotion and unable to function appropriately through the challenges.  

It is important to understand that, for these individuals, the difficulty managing emotion after losing a game has a neurologic base and cannot be generally managed hearing someone say "stop it" or "don't be a cry baby." 

Some ideas for managing these situations coming up in my next post!

Using Technology to Create Social Stories for Children: Adobe Voice

In the past, I have written about using social stories to help children with autism or anxiety deal with apprehension about the unknown or future events.  My previous post was about a birthday party, but social stories can be created for your child about ANY theme such as starting school, night-time routine, going to the dentist, or traveling.  The stories can also be created to help kids learn a new skill such as how to say "I'm sorry" or how to introduce yourself to someone new.

I have recently discovered the free app by Adobe called Adobe Voice.  This app can be used to make stories come alive with icons, photographs, text, graphics, and music. 

Here is a link to the video I created about a birthday party: Birthday Social Story

In this story, I used icons, but you can insert pictures of the child's actual world.  For example, for a social story about the first day of school, you can take photos of the actual school, the teacher, the classroom, his/her bookbag, the school bus, etc and make a video story for your child to watch.   Your child can even help create the video themselves.  They could record their own voice talking about the pictures that are uploaded. 


What is your story?

Helping Kids with Social Anxiety: Giving Them a Role

Some people thrive in a social setting.  They love the people, the celebrations, and joy of interacting with others.  Other people prefer to stick to themselves, and may have a very difficult time in social settings.  When they do want or need to be in a group, they may feel nervous, stressed, and drained.  

I recently had to take my 8 year old son to church with me when I got to lead a prayer service.  There was no where else for him to hang out on that night.  I ended up asking him to be my helper with the "technology" and the music.  I had my ipod and wanted to hook it into the sound system with specific songs playing at specific times.  

This turned out to be a wonderful thing, because I really did benefit from his help with the songs, and he felt very proud and excited that he could contribute.  He did really well in the social setting, even though that would generally be quite a challenge for him if we just showed up and he didn't have a specific role. 

When your kids are going into a crowd, try to think of ways to make roles specific if they like that.  Can they be a helper?  Maybe they can be in charge of opening the door and putting peoples' coats in the "coat room."  Maybe they can help with props for a play rather than being on stage.  Maybe they can help hide the Easter eggs or hand out the Halloween candy.

What have you tried that helps your kids negotiate crowds and parties?

Spring Cleaning and Autism

Everyone probably has a room or rooms in their house in need or spring cleaning!  Anyone with kids knows that things can collect and build up that really should be sorted through and given away.  A challenge for any family is convincing the kids to let go of some of their stuff and give some away to other children.  

Children in the autistic spectrum can have particular difficulty keeping their space organized and free of clutter because of executive function and sequencing difficulties.  Executive function is a primary difficulty within the autistic spectrum.  This includes abilities such as figuring out how to start a multi-step project, initiating behavior, and attending to both the details and the big picture.  In addition, many individuals in the spectrum are very particular about their belongings in the sense that they may have collections, prefer to arrange certain belongings "just so" while other belongings are on the floor, and may resist change (such as changing the location of an object at home or throwing things out that aren't important any more).

One approach that I use with my son in the autistic spectrum is to go through the house while he isn't home, and gather things that I don't see him playing with or using.  Then I store them in boxes and bags out of site. If he notices something is missing and asks for it, I can return it.  But if months have gone by and he hasn't noticed that something is missing, I give the items away.  

I also encourage him to choose some items to give away. Sometimes his school has a charity drive for example that kids can contribute to.  This is a way to focus on the teaching part about having a generous spirit, why that is important, and how to live that out.  

How do you help your autistic child sort through and give up some of their things?  Do they have trouble tolerating the changes?

Exercise to Reduce Anxiety: Even the brain changes

Exercise has been long regarded as an effective way to counter the blues, stress, and anxiety.  There seem to be many benefits including increasing socialization, improving our body image, increasing endorphins, and working off some of our adrenaline and tension.  

Turns out, exercise also changes the brain.  Researchers at Princeton used an animal model of exercise to measure neurons in the brain.  After 6 weeks of exercise, the "running mice were more willing to cautiously explore and spend time in open areas, an indication that they were more confident and less anxious than the sedentary animals."  When the animals were put in stressful situations, the running mice calmed much more easily after the stress than the sedentary mice. 

When they examined the brains of the "running mice," they determined that there was an increase in neurons that produced GABA, a neurotransmitter that calms down brain activity.  This neurologic activity may be true in humans as well!  Another reason, to get some physical activity as part of a healthy lifestyle.  

link to New York Times article and original scientific article in the Journal of Neuroscience

Excerpt Soul Cries Devotional: Praying for Resources for Families in Need

This excerpt from Soul Cries devotional is written for families with struggling kids, but can be applied to any situation where resources are needed.  I am praying this for you today...

Soul Cries devotional, copyright 2012 Regan

Resources

Deuteronomy 8:4 (Amplified Bible)

Your clothing did not become old upon you nor did your feet swell these forty years.

When you are raising a child with special needs, you are likely to feel the pressure of resources and provision, wondering if there will be enough. Will there be enough finances, energy, patience, assistance, or wisdom? I like this verse from Deuteronomy. Moses is reminding the Israelites about God’s provision in the desert. There were times when God provided resources “out of thin air,” such as manna, water, and meat. God also provided for their needs by supernaturally extending the life of their resources. Throughout forty years, their clothing never became old, never wore out, or needed to be replaced. Their bodies didn’t show the expected wear and tear of walking miles and miles through the desert. The expected blisters and swelling never materialized. God extended their resources to meet their needs.

I pray for your household right now, reader. I pray that the God of the desert journey will not only provide new things that you need on your journey, but will supernaturally extend the life of what you already have. I pray that your current resources won’t need to be replaced and won’t show the expected wear and tear. May God cover you with His provision in ways that you can’t explain in the natural!

1. I invite you to watch for ways in which God meets your needs by extending resources in unexplained and unexpected ways.

2. I pray that this provision from God will be a witness to you and your children about God’s heart and His supernatural ways. I encourage you to journal about this part of your journey with God.

How the Brain Impacts Behavior: What All Parents Should Know About Their Kids With Brains

I am a Neuropsychologist, which means I have a PhD specializing in how brain function impacts thinking skills, behavior, emotions, and personality.  My job in a medical center includes advising medical staff on how conditions involving the brain will likely impact the behavior of their patients. I also have a 7 year old son in the autistic spectrum.  

Although the brain does not control behavior, the substrate of the brain and how it is wired does influence behavior and the range of behaviors people are capable of.  This is important for parents to know, as their kids are likely each different with regard to their gifts, challenges, and what they are capable of at different ages and in different settings. 

These are 5 things about the brain every parent should know:
1. All Behavior is Communication
All behavior communicates something.  If you see your child melting down, what is that behavior communicating?  What about when your child is a picky eater? What does it mean when your child's behavior changes from day to day?  
2. Many Behaviors Are Influenced by Brain Function
Whether your child has developmental delays, is right on time, or is gifted, some of the behaviors you see are likely to have some basis in how their brain is wired.  
3. Discipline Alone is Not Likely to Produce the Most Success
Discipline is asking your child to self-regulate, that is to control their own behavior, using their cortical function (their thoughts and will).  The reason the success of discipline is limited, is that it assumes that the child can control the behavior in question, and that the reason for the problematic behavior is a decision on the part of the child not to behave.  Don't get me wrong, I'm all for discipline, but only in combination with identifying why the behavior occurs, and then teaching the child how to meet their needs without harming others or while remaining safe. 
4. Make Sure Your Expectations For That Child Are Reasonable
There is nothing that creates a recipe for failure and frustration more than asking someone to do something they are not capable of.  For example, if I sit my 2 year old down and try to teach him nuclear physics, he will be overwhelmed and unable to achieve the goal, and I will be frustrated that he isn't doing what I ask him to do!
5. Behaviors That Stem From Brain Function Will Be Inconsistent
Many people make the mistake of saying, "If they want to they can do it" because the person's behavior is inconsistent.  In actuality, if the brain is involved, there will be inconsistency in behavior at different times and across different settings.  If there is inconsistency, we should start to wonder if the brain is involved in any way.  

So, with that in mind, let's take meltdowns as an example.  Meltdowns may communicate that a child is overwhelmed, overtired, or unable to communicate with words.  A lot of times, people who are feeling a strong emotion, become "at a loss for words."  They actually can't activate the language centers enough to put their emotions and thoughts into words.  Maybe your child is feeling frustrated or upset and doesn't know how to manage that emotion.  Your child may be overstimulated (too much chaos, sensory input) in a crowded place like a store or a school.  After figuring out what the behavior is communicating, you have a great opportunity to help your child by taking them to a quieter place, teaching your child ways to calm down, and see if language returns better as your child calms down.  Discipline alone, which would require that your child regulate their own behavior even when they don't know how or feel overwhelmed, will be less effective. 

Let's take the preschool child who is banging his/her legs against the chair while waiting for lunch at preschool or daycare.  Let's say they have been waiting for 20 minutes and the meal is running late.  The teacher tells them to stop banging their legs because it is impolite; the teacher explains the disciplinary consequence if they continue to be rude at the table.  But, remember, all behavior is communication.  Can we expect this preschool child to sit quietly at a table for 20 minutes?  What the teacher doesn't realize is that banging his/her legs against the chair is giving the child proprioceptive input into the ankle joints.  Guess what proprioceptive input does?  It helps with self-regulation...calming a person who is hyperactive and antsy, while alerting a person who is falling asleep or losing focus.  So the child is actually trying to self-regulate by banging his/her legs; they are unable to regulate from top-down (from cortex thinking brain centers to lower centers) so they use a bottom-up brain strategy (sensory input comes from a lower part of the brain and helps regulate behavior when thoughts cannot).  

There are so many more examples.  See my other posts about kids, anxiety, autistic spectrum, and sensory symptoms for more.  

What Is High Functioning About Autism?

 

What is High Functioning about Autism?  

(above see Temple Grandin and Steven Wiltshire--Each with autism and great giftings)

You may hear the description "high functioning" connected to the word autism.  What does that mean? Does it mean the person is high functioning with relationships, work, play, mood?  Does it mean there are no struggles or challenges?  Are these individual higher functioning than others outside the spectrum?  Great questions!

High functioning only refers to an individual's cognitive function.  There is a misperception that most individuals in the autistic spectrum are low functioning cognitively.  In fact, when I was in graduate school, we learned that 2/3 of individuals in the spectrum are intellectually handicapped and measure in what we call the Mentally Retarded range.  Turns out, that was a huge error! While it is difficult to measure exactly  how many people are in the autistic spectrum from different ranges of "intellect"--it is clear that autism does not discriminate on the basis of intellect. In fact,it is becoming clear that many people who are in the gifted range of intellect are within the spectrum.  They may be described as having high functioning autism or Asperger's Disorder.  Some argue there is a difference between the two and others argue they are the same.  For the sake of this discussion, we don't need to solve that question! 

But let's get back to the original question.  Does that mean the individual is "high functioning" in life?  No.  These individuals may be high functioning and accomplished in life, but many have significant struggles in certain areas, or at least need some accommodations or help to maintain their really functional life.  Why?  Consider this--
     1. Although I said high functioning refers to cognition, I should say it refers to intellect.  There is a cognitive domain called executive function that is very problematic in the autistic spectrum.  It involves things like multi-tasking, initiating a task, time management, flexible thinking, quick attention, thinking outside the box, sequencing through a task with multiple steps, etc.  (See my other posts on executive function by clicking on the tags/labels on the right hand column). 
     2. In addition to significant problems with executive function, individuals in the spectrum also tend to have difficulty with social communication, facial recognition, and imaginative play with others.  Therefore, relationships can be problematic and difficult to maintain well. 
     3. Individuals in the spectrum often have significant sensory symptoms (see sensory tag). This can mean that they feel drained in their environment, well before others would.  They may need things "just so" to get through the day well (e.g., wearing a certain type of clothes, eating certain foods, dimmer lights etc). 
     4. Anxiety is very prevalent in the spectrum.  Anxiety and executive function problems may cause rigidity in day to day functioning.  Also, anxiety is more difficult to treat with medications in the spectrum than outside (although can certainly be helped with medication).  Counseling may be difficult because it can rely on thinking abstractly in an interpersonal setting.  E.g. "What are you feeling?"  Counselors who specialize in treating individuals in the spectrum may use an approach based on problem solving, teaching self-monitoring, and learning social skills. 
      5. Sleep disturbance is often present.  This can be very disruptive if the individual is unable to initiate sleep, maintain sleep, and have good functioning during the day when they need to be at work, engaging with family, etc.  
      6. Individuals in the spectrum may have special interests that consume all their time. They may have collections that turn into hoarding.  They may spend so much time playing video games, organizing baseball cards, and building lego sets, that they don't maintain other aspects of their life well.

So beware--- If you see a child or adult struggling, consider whether they may have spectrum symptoms.  Being "high functioning" with intellect does not rule out a neurologic problem causing pain and impairment. I once heard a preschool teacher refer to a young boy in her class by saying "I don't know what's wrong with him! He's not stupid!"  As a culture, we are not good at recognizing high functioning autism, as this boy clearly had.  She was right--he wasn't stupid.  He was a gifted artist and a bright boy.  But, he was struggling, as were his parents, and they were unable to get help and assistance because autism was the furthest from their mind.  Why?--because he wasn't stupid.  

Let's increase our understanding of autism, both "high functioning" and for individuals with less language and problem solving.  Let's focus on recognizing the symptoms in the young and old.  We will improve our schools, homes, and communities. 

Triumphs and Tragedies: What Is The Meditation of Your Heart?

There are often tragedies around us, perhaps on the news, in our neighborhood, in our households.  Why is it so easy to meditate on these things, to sit in front of the television and stare for hours at destruction?  Why is it so easy to keep talking to friends about the sadness that occured, about the struggles and difficulties of our friends?  Do we also talk for hours about the wonderful things, the triumphs, the breakthroughs, the unexpected blessings? 

I am not suggesting we turn a blind eye to what is happening, good or bad.  Do you have a health symptoms?--get it checked out.  Are there people grieving in your neighborhood?--comfort them.  I am speaking here about the meditation of our heart.  What do we meditate on for hours.  What do we let live and grow in our spirit?  Where is our attention and focus?  We give power to whatever we are giving our focus to...We should chose wisely.

Consider Matt Redman's song 10,000 reasons--

I love the clip of lyrics here: "Whatever may pass, and whatever lies before me, Let me be singing when the evening comes"

Let's choose to focus on goodness.  There are 10,000 reasons to sing...  Join me in the song.

10,000 Reasons Sung by Kim Walker-Smith

Sensory Strategies to Help Infants and Children Calm

Everyone uses sensory strategies to feel better, whether they realize it or not.  What is a sensory strategy?  How about when we use lavender or vanilla scents in soaps or lotions and take a deep breath...ahhh, that feels good.  Consider your morning routine-- maybe you take a hot shower and the heat feels good.  Maybe you make hot coffee and eggs for breakfast, and the heat and smell of the meal is filling as much as the calories themselves.  Maybe a massage feels great, or cuddling up in a chair with a blanket.  Maybe being "tucked in" tight in the covers at night or sleeping among multiple pillows feels wonderful.  

Those are all sensations that help our body feel calm and relaxed and wonderful.  Children respond to sensory strategies too, they just may not notice what feels good.  Some kids have "normative" sensory experiences and may regulate themselves fairly well during the day but enjoy some calming sensory inputs here and there.  Other children may have sensory processing disorder or be within the autistic spectrum.  These kids may need more calming input than other children because of the way their nervous system is wired. Some calming strategies may include deep pressure and/or gentle movement (vestibular input).

Here are some ideas for calming sensory inputs--
1. swaddling blankets or slings for infants

This deep pressure feels wonderful and cuddly to infants.  The one thing I wished I had purchased before bringing my son home as an infant was a swaddling blanket that was actually created for that purpose.  These baby slings are the same concept.  Not only does the infant experience deep touch, which is calming, but they are close to their parent, warm, and comforted. Also, if the parent is bouncing them or swaying back and forth, they are receiving gentle vestibular input (movement) and this also feels calming.
2. For bigger kids, consider different techniques to give them deep touch, pressure, and vestibular input for comfort.
.........a.  Bean bag chairs
You can use simple ones that you pick up at a store or can use more specialized ones as below; these can be found through sensory catalogues and internet sites with products for sensory dysfunction or autistic spectrum.

 ........b. Hammocks or hammock swings
Think about how a hammock envelopes you and even gives you a gentle swaying feeling that is comforting and calming.  The hammock swings below are a bit more specialized and can be found in sensory catalogues. 

.......c. You can also wrap your child with gentle but firm pressure in something like a yoga mat.  Play a game and tell them you are making an "Thomas" taco for example. 

Or you could make a "Thomas" sandwich using pillows in which the child is laying on a large pillow and has a pillow on top.  You can apply gentle pressure on the top pillow pretending you are assembling the sandwich. Encourage the child to tell you what feels good, when to keep going, and when to stop.  
.......d. Use a heavy blanket over your child.  There are even specialized weighted blankets that are heavier than the norm and are used for calming kids with anxiety, sensory needs, autistic spectrum, and more.  Many sites on the internet sell weighted blankets and I have a previous post on just that subject (Information on Weighted Blankets).  The picture below shows a child in a cute little "envelope" in which the top portion is weighted.

Whatever is calming for you or your child, use it.  Our brain responds well to sensory input that helps us regulate our nervous system.  Play detective to see what types of input, when and how much feel good to you or your kids.  If you would like more professional input in this area for your child, an Occupational Therapist can help.

Helping Kids with Intepersonal Transitions: Hello and Goodbye

Some children, particularly in preschool years or younger elementary grades, have difficulty with interpersonal transitions.  They may have a hard time adjusting to the arrival of the babysitter or saying goodbye to visiting relatives.  They may have trouble saying goodbye to a teacher at the end of the year or to a parent leaving them at school/daycare. 

One of the things that helps my son with those transitions is to add some structure, so he knows what to expect.  This structure ends up being kind of a routine, something he can "count on" even though his interpersonal moment is in flux.  He knows his role in this scenario, and he is reassured that he can anticipate what is coming.  

When my son was two and three, he had difficulty when the babysitter arrived even though he knew her well.  We developed a short routine where he would always pick something ahead of time to "show her" when she came.  This way, he knew his role at the time of the greeting and could count on there being something "expected."  He felt more in control as well, as if to say "Hi.  This is my space and I'm letting you come in.  I'm showing you something I like.  I'm choosing to invite you in."

We have developed another tradition for when his Nana and Papa are leaving to go back to their home in Michigan after a several day visit.  

My parents draw him a picture reminding him of what they did together, that they love him and will be driving home, and that they will see him next time.  After we say good bye at the door and talk about when we will see them next, Joshua runs through the house to find the picture which is accompanied by a small gift.  This time, he received a Star Wars toothbrush that lights up like a light saber.

What kinds of traditions and routines help your youngster deal with interpersonal transitions?

Gut Bacteria and Mood

Trillions of bacteria live in our gut; in fact, the number of bacteria out-number our own cells about 10:1.  The gut is also home to 100 million neurons and is often called the "second brain."  Not only that, but 60-70% of our immune system is within the gut.  

Many people are aware that we all have "good bacteria" and "bad bacteria" within the digestive system.  Having 85% good bacteria is considered "normal."  

The incredible thing is that research with animals models is finding that the content and ratio of bacteria in the gut impacts behavior and "mood."  By changing the types of bacteria in the gut of animals, they have seen notable changes, primarily within behaviors that are described as "anxious" (e.g., animals can be seen as more cautious, timid, or reluctant to engage in new environments) vs. bold and adventurous.  The impact also works the other way.  When significant stress is introduced, the stress chemicals released can change the flora of the gut and therefore negatively impact immune function.  

This type of research may impact how we treat individuals with anxiety and mood symptoms.  In the future, doctors may want to test the bacterial flora and alter it to a more healthy state to see if this improves symptoms. 

To read more, connect to this article--That Gut Feeling: article in APA monitor

One reason I find this so interesting, is that my son is in the autistic spectrum and has difficulties with anxiety.  We notice that when he is on an antibiotic for a while, he seems worse.  We also feel he does better with a probiotic supplement to increase his good bacteria.  Many individuals within the autistic spectrum are noted to have significant allergies (immune issues) and digestive problems but no one knows why.  I will be watching for research that connects the gut, immune system, and autistic spectrum in some way...

What do you think?

Social Stories: parenting tool

A social story can be used with kids for a variety of purposes.  Many times, the stories are used for children in the autistic spectrum.  But of course many children who are outside the spectrum have difficulty with change, transitions, and social situations.  Your child may have anxiety or upset about a new year at school or an appointment at the dentist.  Maybe your child reacts inappropriately or without positive problem solving in some situations, and you would like to give them a "script" for acting in a different way. 

With my son, we use social stories primarily for issues of change and transition, when he is feeling nervous or reluctant about a situation.  Even if a fun party is coming up, my son likes to hear the "story" of what is going to happen ahead of time, and rehearse it in his mind like a script or movie. 

The story to the left is one that a parent devised with words and pictures to describe what a trip and Dr's appointment would feel like.  It is a "what to expect" story. 

My son recently had a birthday party because he turned 7.  He gets very excited about things like that, but also overwhelmed, not knowing how to handle the adrenaline.  "Am I feeling nervous or excited?  I feel uncomfortable."

I told him a story something like this:
Once upon a time, Joshua had a birthday party.  He was turning 7; what a wonderful number 7 is.  Joshua's friends wanted to celebrate with him and have fun.  So, on Saturday, 3 of Joshua's friends came to play, eat cake, and open presents.  Joshua felt excited but a little nervous.  On Saturday, mom decorated the table with green decorations and made a Lord of the Rings cake.  After I ate lunch, I helped her finish the decorations.  Mom told me that the boys would be here in 10 more minutes.  When the boys came, I opened the door and said "friend or foe!"  They laughed and came in.  We played with our swords first, like Lord of the Rings.  Mom gave us a 10 minute warning before it was time to stop playing and eat cake and ice cream.  The cake was chocolate and the ice cream was mint chocolate chip.  It was so good, I wished I could have more.  Next, I opened presents.  I knew that I might get a present that I didn't really want, or that I already have.  When that happens, I know to take a deep breath and say "Thanks!  You are such a good friend!"  I want to make my friends feel special.  After we opened presents, I played with my friends again before their parents pick them up.  What a good, tiring, and fun party.  After the party was rest time.  

After I told him the story, he said "tell it to me again."  He likes the story and repetition; it feels grounding.  One thing to consider is that unexpected things always happen.  This is a good learning tool as well.  At some point in the story, I typically add..."And this is how it happened...unless something unexpected happens.  It usually does and that's ok."  

How do you help your child with transitions?