Going to the supermarket with a child with autism can be a stressful experience for parents concerned about serious behavior problems. They worry that their child might throw a tantrum, run away, talk to or touch other shoppers inappropriately, or open food items before they are purchased. A successful visit, on the other hand, can make this routine family chore much more pleasant, and presents the child with numerous opportunities for learning.

What can parents do to make these trips successful? First, bear in mind that success requires both the direct teaching of necessary skills and the consistent managing of behavior problems. Parents should employ a structured teaching and behavior management plan that includes proven procedures such as teaching in small steps, presenting frequent opportunities for practice, providing clear instructions and assistance, using positive rewards, and having a consistent response to any behavior problems if they occur.

Parents should work with their child's school to ensure that specific goals - such as learning supermarket skills - are included in their child's Individual Education Plan (IEP). Then, instruction can be individually designed for the child in a way that both parents and teachers can implement. It is very important to select and consistently implement a strong reward system, especially during the early stages of instruction.

For most children, instruction should begin in simulated practice settings at home or in school before moving on to a small grocery or convenience store. The child should be able to follow a number of basic instructions in a more controlled environment before visiting a larger supermarket.

Developing a plan to address problem behaviors is an important component in the training program. The plan should be the same for school and home. Immediately leaving the store and not providing a reward can be effective, unless the child's behavior problems occur because he or she wants to leave the store. "Giving in" and offering the child a toy or edible treat to avoid or stop a tantrum may be effective for the moment, but will likely make the problem worse in the future.

Shannon Kay, Ph.D., director of the May Center in West Springfield, recommends teaching the child the following instructions:

- "Come here." Use two adults to teach so rewards and assistance can be provided immediately. Start with a small distance - about six feet - between child and adults.

- "Stop." Also use two adults so you do not have to chase the child if he or she does not comply.

- "Hold my hand." Give the child a reward for walking small distances (15 feet) while holding an adult's hand without pulling away or falling on the floor.

- "Stay with me." After holding hands is mastered, reward the child for walking small distances and staying next to the adult.

- "Wait in line with me." Start with very short lines.

Once the child masters the basic skills outlined above, the supermarket experience will be much more positive for both the parent and the child. Then, more advanced supermarket skills can be taught, such as making and using a shopping list, locating one or more items from the list, pushing the cart appropriately, asking for help from a store employee, and mastering counting and other money skills.

I would encourage parents to avoid stores that are too large and/or crowded, and to keep the initial visits brief. It is better to have multiple short successes and slowly build up to longer, successful outings.

May Institute operates schools for children and adolescents with autism and other developmental disabilities in Chatham, Randolph, West Springfield, and Woburn, Mass., and in Freeport, Maine. The Institute also provides residential and day services for adults. For more information, call 800-778-7601, or visit www.mayinstitute.org.

Dr. Harchik can be contacted in West Springfield at 413-734-0300, or at aharchik@mayinstitute.org.

The information presented on this site is intended solely as a general educational aid, and is neither medical nor healthcare advice for any individual problem, nor a substitute for medical or other professional advice and services from a qualified healthcare provider familiar with your unique circumstances. Always seek the advice of your physician or other qualified healthcare professional regarding any medical condition and before starting any new treatment.